Individual
SHANTA MARIE HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
4044 WATERS END LN, SNELLVILLE, GA 30039-6849
(678) 524-1883
Mailing address
4044 WATERS END LN, SNELLVILLE, GA 30039-6849
(678) 524-1883
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP0067339
GA
Other
Enumeration date
06/18/2008
Last updated
06/18/2008
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