Individual
DR. MARY NICOLE HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, RD
Contact information
Practice address
747 52ND ST, OAKLAND, CA 94609-1809
(510) 428-3885
(510) 428-3284
Mailing address
747 52ND ST, OAKLAND, CA 94609-1809
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
01/26/2013
Last updated
01/26/2013
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