Hendricks, Kelly Rae

Hendricks, Kelly Rae is an individual health care provider with primary practice located at 230 Park St , Wautoma WI 54982-9031. She recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as her primary health care specialty. Hendricks, Kelly Rae can be contacted via phone (920) 787-6550.

Contact Information

Primary practice address
230 Park St Wautoma WI 54982-9031
Phone: (920) 787-6550
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X

Profile Details

NPI number 1932858263
LBN Legal business name Hendricks, Kelly Rae
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2022
Last updated Mar 23rd, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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