Organization
DANA HENDERSON, PH.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANA HUGHES HENDERSON PH.D. (PRESIDENT)
(404) 247-9274
Entity
Organization
Contact information
Practice address
2952 VININGS FOREST WAY SE, ATLANTA, GA 30339-4222
(404) 247-9274
(770) 434-8830
Mailing address
2952 VININGS FOREST WAY SE, ATLANTA, GA 30339-4222
(404) 247-9274
(770) 434-8830
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
PSY001261
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000477837A
—
GA
Enumeration date
10/22/2009
Last updated
10/22/2009
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