Individual
BETHANY P HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4900 IVEY RD NW STE 1720, ACWORTH, GA 30101-4101
(334) 796-2414
Mailing address
4900 IVEY RD NW STE 1720, ACWORTH, GA 30101-4101
(334) 796-2414
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
120817
TX
225X00000X
Occupational Therapist
Primary
OT008314
GA
Other
Enumeration date
04/06/2020
Last updated
01/17/2022
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