Individual
KATHY A. HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CAC-1
Contact information
Practice address
19941 GALLAGHER ST., DETROIT, MI 48234-1655
(313) 331-8990
Mailing address
19941 GALLAGHER ST, DETROIT, MI 48234-1655
(313) 331-8990
(313) 331-6375
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
1-00030
MI
Other
Enumeration date
03/05/2008
Last updated
03/05/2008
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