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Individual

DANIEL R HENDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
1870 LEONARD NE, GRAND RAPIDS, MI 49505
(616) 956-1122
(616) 956-8033
Mailing address
PO BOX 30516, DEPT 6001A, LANSING, MI 48909-8016
(616) 235-2090
(616) 235-2099

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301007492
MI

Other

Enumeration date
03/24/2006
Last updated
11/08/2007
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