Provider Demographics
NPI:1457651416
Name:KENDHAMMER, KRISTA ASHLEY (MSW)
Entity Type:Individual
Prefix:MS
First Name:KRISTA
Middle Name:ASHLEY
Last Name:KENDHAMMER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2458 AVENIDA CORTES
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-6349
Mailing Address - Country:US
Mailing Address - Phone:720-484-1922
Mailing Address - Fax:
Practice Address - Street 1:522 E LAKE MEAD PKWY
Practice Address - Street 2:5
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-5530
Practice Address - Country:US
Practice Address - Phone:702-486-6723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical