Provider Demographics
NPI:1669756482
Name:HENDLEY, CHRISTA MARIE (DAT, LAT, ATC, GTS)
Entity type:Individual
Prefix:MS
First Name:CHRISTA
Middle Name:MARIE
Last Name:HENDLEY
Suffix:
Gender:F
Credentials:DAT, LAT, ATC, GTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 REDDING RD APT 2103
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-2548
Mailing Address - Country:US
Mailing Address - Phone:859-962-9338
Mailing Address - Fax:
Practice Address - Street 1:7790 COLLEGE STATION DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:KY
Practice Address - Zip Code:40769-1388
Practice Address - Country:US
Practice Address - Phone:606-304-3659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-29
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAT12312255A2300X
KYKRS 311.9052255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer