Individual
SARAH HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, LCSW
Contact information
Practice address
321 CORPREW ST, FAYETTE, MO 65248-1127
(660) 248-1309
Mailing address
321 CORPREW ST, FAYETTE, MO 65248-1127
(660) 248-1309
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2004014814
MO
163W00000X
Registered Nurse
122543
MO
Other
Enumeration date
08/20/2010
Last updated
08/20/2010
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