| Doctor Name: | DR. VICKIE MARIE HENDRICKS |
| NPI Number: | 1215081195 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD |
| License Number: | |
| Business Practice Address: | 4990 Rte 159 Glen Carbon, IL - 62034 |
| Business Phone Number: | 6182881365 |
| Business Fax Number: | |
| Mailing Address: | 4990 Rte 159, GLEN CARBON |
| State: | IL |
| Postal Code: | 62034 |
| Phone Number: | 6182881365 |
| Fax Number: | |
| NPI Enumeration Date: | 01/22/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |