NPI 1902451792

Jacqueline Hendricks

Practitioner Prevention Professional Las Vegas, NV

Practice location

Address: 4525 Dean Martin Dr Unit 501, Las Vegas, NV 89103-8107
Phone: (904) 504-7234

Registered specialties

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X Licence 251268 (FL)

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Registry record

NPI: 1902451792
Entity type: Individual
Sex (as registered): Female
NPI issued: 7 Aug 2019
Record last updated: 7 Aug 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.