Individual
DR. CHARITY ANN PLAXTON HENNINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1881 BUSINESS CENTER DR, SUITE 11, SAN BERNARDINO, CA 92408-3465
(909) 553-0547
(909) 384-0734
Mailing address
PO BOX 659, BRYN MAWR, CA 92318-0659
(909) 553-0547
(909) 384-0734
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
20627
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20627
LICENSE NUMBER
CA
Enumeration date
06/20/2008
Last updated
03/03/2009
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