Individual
BRITTANY DIANE HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
4255 PHEASANT RIDGE DR NE STE 412, BLAINE, MN 55449-5066
(763) 703-3754
Mailing address
665 KINGFISHER LN APT C, WOODBURY, MN 55125-1843
(651) 703-1681
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/03/2019
Last updated
08/19/2022
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