Individual
LAURA HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
1165 MONTGOMERY DR, SANTA ROSA, CA 95405-4897
(707) 525-5300
Mailing address
P.O. BOX 1084, HEALDSBURG, CA 95448
(707) 494-4488
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1084604
CA
Other
Enumeration date
10/21/2015
Last updated
11/27/2019
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