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Individual

F THERESA HENDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
22401 FOSTER WINTER DR, SOUTHFIELD, MI 48075-3724
(248) 423-5100
Mailing address
2726 MAITLAND DR, ANN ARBOR, MI 48105-1565
(734) 761-8150

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704148321
MI

Other

Enumeration date
05/10/2006
Last updated
12/09/2011
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