Provider Demographics
NPI:1518553155
Name:HENDRY, CORIN GAYLE
Entity Type:Individual
Prefix:MS
First Name:CORIN
Middle Name:GAYLE
Last Name:HENDRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:649 W 2ND AVE APT 9
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-8017
Mailing Address - Country:US
Mailing Address - Phone:530-588-1289
Mailing Address - Fax:
Practice Address - Street 1:580 HAZEL STREET
Practice Address - Street 2:
Practice Address - City:GRIDLEY
Practice Address - State:CA
Practice Address - Zip Code:95948
Practice Address - Country:US
Practice Address - Phone:530-846-7305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Single Specialty