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Individual

DR. ANGELA L. HENDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
3111 MAHAN DR, SUITE 20, TALLAHASSEE, FL 32308-5548
(850) 656-1192
(850) 386-1300
Mailing address
3111 MAHAN DR, SUITE 20, TALLAHASSEE, FL 32308-5548
(850) 656-1192
(850) 386-1300

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY7246
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
767622100
FL
Enumeration date
05/22/2009
Last updated
05/22/2009
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