Individual
MS. JOANN H. HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSW, MA, LPC, QMRP
Contact information
Practice address
409 BRETHREN RD, BROADWAY, VA 22815-2847
(540) 476-1482
(540) 896-3209
Mailing address
PO BOX 103, BROADWAY, VA 22815-0103
(540) 476-1482
(540) 896-3209
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701004506
VA
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4946995
—
VA
Enumeration date
03/07/2006
Last updated
02/11/2009
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