Individual
MS. CARLY MARIE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., LPC, LMHC
Contact information
Practice address
3407 S CORBETT AVE, PORTLAND, OR 97239-4621
(971) 270-0658
(971) 244-7268
Mailing address
1016 SE 12TH AVE, PORTLAND, OR 97214-2513
(971) 270-0658
(971) 244-7268
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C3645
OR
Other
Enumeration date
05/13/2011
Last updated
02/21/2024
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