| Doctor Name: | PAULETTE THERESA HENDRICKS |
| NPI Number: | 1912246620 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW-C |
| License Number: | 06378 |
| Business Practice Address: | 17826 New Hampshire Ave Ashton, MD - 208619781 |
| Business Phone Number: | 8004915369 |
| Business Fax Number: | |
| Mailing Address: | 4216 Wynfield Dr, OWINGS MILLS |
| State: | MD |
| Postal Code: | 211176171 |
| Phone Number: | 4109604760 |
| Fax Number: | |
| NPI Enumeration Date: | 02/01/2013 |
| NPI Last Update Date: | 02/01/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 06378 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |