Individual
MRS. KOLLEEN OBANNON HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3469 N VERDUGO RD, GLENDALE, CA 91208
(818) 249-6636
(818) 249-5074
Mailing address
3469 N VERDUGO RD, GLENDALE, CA 91208
(818) 249-6636
(818) 249-5074
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
350799
CA
Other
Enumeration date
10/13/2006
Last updated
06/07/2012
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