Individual
KAYLENE SCHOLL HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
52 SUNFLOWER CT, ELLIJAY, GA 30540-3054
(706) 455-9028
(706) 455-9028
Mailing address
52 SUNFLOWER CT, ELLIJAY, GA 30540-5120
(706) 455-9028
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
253J00000X
Foster Care Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
08/22/2017
Last updated
08/22/2017
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