Provider Demographics
NPI:1053894667
Name:HENDRICKSON, RACHEL (MA)
Entity type:Individual
Prefix:MISS
First Name:RACHEL
Middle Name:
Last Name:HENDRICKSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 CRESCENT STREET
Mailing Address - Street 2:APT 507
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453
Mailing Address - Country:US
Mailing Address - Phone:786-376-6984
Mailing Address - Fax:978-927-1758
Practice Address - Street 1:780 AMERICAN LEGION HIGHWAY
Practice Address - Street 2:
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02131
Practice Address - Country:US
Practice Address - Phone:857-225-6434
Practice Address - Fax:617-469-8595
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist