Individual
LAURA HENDERSHOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN BSN
Contact information
Practice address
829 HALBERT ST, MALVERN, AR 72104-2607
(870) 557-3238
Mailing address
829 HALBERT ST, MALVERN, AR 72104-2607
(870) 557-3238
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
RN710436
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RN710436
—
TX
Enumeration date
01/24/2014
Last updated
01/24/2014
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