Individual
STACY HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
865 N ARIZOLA RD, CASA GRANDE, AZ 85122-6011
(520) 836-3446
Mailing address
2316 W ARROYO WAY, QUEEN CREEK, AZ 85144-3140
(480) 387-0573
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/18/2024
Last updated
03/18/2024
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