Individual
MS. KRISTA ANN HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.T.
Contact information
Practice address
1220 E 2ND AVE, MONMOUTH, IL 61462-2404
(309) 734-7902
Mailing address
300 N MAIN ST, ROSEVILLE, IL 61473-9633
(309) 426-2456
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
04/10/2007
Last updated
07/08/2007
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