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Individual
DEWANNA HENDERSON
Active
Individual
DEWANNA HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C, BA
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
TX
363A00000X
Physician Assistant
2315
TN
363A00000X
Physician Assistant
7034
GA
Other
Enumeration date
02/10/2013
Last updated
01/17/2017
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