Individual
JODIE MARIE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-MHSP TEMP
Contact information
Practice address
508 E UNAKA AVE, JOHNSON CITY, TN 37601-4033
(423) 810-0961
Mailing address
508 E UNAKA AVE, JOHNSON CITY, TN 37601-4033
(423) 810-0961
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6603
TN
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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