Individual
DR. PAMELA JOY HENDERSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PSYD, LP
Contact information
Practice address
408 SAINT PETER ST, SUITE 429, SAINT PAUL, MN 55102-1130
(651) 224-0614
(651) 224-5754
Mailing address
408 SAINT PETER ST, SUITE 429, SAINT PAUL, MN 55102-1130
(651) 224-0614
(651) 224-5754
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3567
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116625
U CARE
—
01
—
21D53HE
BC/BS
—
01
—
61-00942
MEDICA
—
Enumeration date
07/29/2005
Last updated
07/08/2007
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