Individual
ELSIE AGURS HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS-A
Contact information
Practice address
2505 COURT DR, GASTONIA, NC 28054-2140
(704) 842-6359
Mailing address
2505 COURT DR, GASTONIA, NC 28054-2140
(704) 842-6359
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
28389
NC
Other
Enumeration date
04/19/2023
Last updated
04/19/2023
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