Individual
DAVEY HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12641 E. EARLL DRIVE, AVONDALE, AZ 85392
(602) 316-9834
Mailing address
12641 E. EARLL DRIVE, AVONDALE, AZ 85392
(602) 316-9834
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
1230257
AZ
Other
Enumeration date
12/01/2010
Last updated
12/01/2010
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