Individual
MITZI HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
500 W MAIN ST STE 302, RUSSELLVILLE, AR 72801-3630
(479) 264-0606
Mailing address
500 W MAIN ST STE 302, RUSSELLVILLE, AR 72801-3630
(479) 264-0606
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7671-C
AR
Other
Enumeration date
09/05/2013
Last updated
09/08/2021
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