Most Relevant Information
Provider Data
| NPI Number: | 1003597006 |
| Provider Name: | KAITLYN ASHLEY HENDRICKSON |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-23-287746 |
Most Important Dates
| Enumeration Date: | 07/31/2023 |
| Last Updated: | 07/31/2023 |
Provider Practice Location
4851 BRIGHTON AVE APT G
SAN DIEGO
CA
921072583
Practice Location Phone/Fax
| Phone: | 9162847132 |
| Fax: |
Provider Mailing Location
4851 BRIGHTON AVE APT G
SAN DIEGO
CA
921072583
Provider Mailing Phone/Fax
| Phone: | 9162847132 |
| Fax: |