Individual
SAMARA HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8000 BRIDLE LN NE, WARREN, OH 44484-1403
(216) 260-1405
(330) 632-8823
Mailing address
2359 KNOLLWOOD AVE, YOUNGSTOWN, OH 44514-1525
(216) 260-1405
(330) 632-8823
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
172V00000X
Community Health Worker
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
10/11/2021
Last updated
07/30/2024
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