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Individual

DANIEL LEE HENDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
63 COLLEGE AVE, SOMERVILLE, MA 02144-1957
(617) 623-3278
Mailing address
63 COLLEGE AVE, SOMERVILLE, MA 02144-1957

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
715
MA
1041C0700X
Clinical Social Worker
Primary
210744
MA

Other

Enumeration date
01/09/2013
Last updated
01/09/2013
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