Individual
JULIE LYNN HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
300 EL CAMINO REAL, SIERRA VISTA, AZ 85635-2812
(520) 417-4994
(520) 417-4994
Mailing address
300 EL CAMINO REAL, SIERRA VISTA, AZ 85635-2812
(520) 417-4994
(520) 417-4994
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
836625
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00836625
AMERICAN DIETETIC ASS.
AZ
01
—
836625
CDR
AZ
Enumeration date
11/01/2006
Last updated
07/08/2007
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