Individual
MICHELLE MARIE HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
119 LAKESHORE DR, VALENTINE, NE 69201-9300
(402) 322-0241
Mailing address
119 LAKESHORE DR, VALENTINE, NE 69201-9300
(402) 322-0241
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/24/2025
Last updated
01/24/2025
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