Individual
CHARLES HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5525 E 51ST ST STE 400, TULSA, OK 74135-7467
(918) 712-0859
Mailing address
11115 E 29TH ST, TULSA, OK 74129-7819
(918) 933-8124
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OK
Other
Enumeration date
05/13/2015
Last updated
05/13/2015
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