Individual
JESSICA D HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
444 W FORT ST FL 2, BOISE, ID 83702-4535
(208) 422-1018
Mailing address
3944 NE 15TH AVE, PORTLAND, OR 97212-1321
(919) 280-9880
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L7552
OR
Other
Enumeration date
03/26/2019
Last updated
10/06/2023
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