Individual
STACY ANNE HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
69 SAND PIT RD, SUITE 204, DANBURY, CT 06810-4004
(203) 798-6986
Mailing address
69 SAND PIT RD, SUITE 204, DANBURY, CT 06810-4004
(203) 798-6986
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001090
CT
Other
Enumeration date
07/12/2006
Last updated
10/26/2010
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