Individual
MS. DAWNA MARIE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3111 CHANNING WAY, IDAHO FALLS, ID 83404-7534
(208) 529-0067
Mailing address
957 HOOPES AVE APT 204, IDAHO FALLS, ID 83404-4709
(307) 220-8919
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1986
ID
Other
Enumeration date
09/27/2018
Last updated
09/27/2018
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