Individual
JEFF HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1680 W IRON SPRINGS RD, SUITE 102, PRESCOTT, AZ 86305-3313
(928) 458-6634
(928) 445-2919
Mailing address
PO BOX 11464, PRESCOTT, AZ 86304-1464
(928) 458-6634
(928) 541-1422
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
4041
AZ
103TC1900X
Counseling Psychologist
5653842-2501
UT
Other
Enumeration date
09/20/2006
Last updated
12/15/2019
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