Individual
REBECCA MARIE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
12351 E BRADSHAW MOUNTAIN RD UNIT 176, DEWEY, AZ 86327-6070
(714) 274-3590
Mailing address
12351 E BRADSHAW MOUNTAIN RD UNIT 176, DEWEY, AZ 86327-6070
(714) 274-2590
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LAC-22641
AZ
101YP2500X
Professional Counselor
Primary
LAC-22641
AZ
Other
Enumeration date
03/08/2024
Last updated
03/08/2024
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