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Individual

MRS. DEBRA L. HENDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
3918 PECAN GROVE RD, RUDY, AR 72952-9026
(479) 632-6337
(479) 632-5916
Mailing address
3918 PECAN GROVE RD, RUDY, AR 72952-9026
(479) 632-6337
(479) 632-5916

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OTR967
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
149798721
AR
Enumeration date
01/23/2007
Last updated
06/13/2008
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