Individual
AMBER HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2004 JEFFERIES HWYV, WALTERBORI, SC 29488
(843) 549-6536
Mailing address
1050 RIBAUT RD, BEAUFORT, SC 29902-5400
(843) 549-8899
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
576000922
BEHAVIORAL HEATH AND SOCIAL SERVICE PROVIDERS
SC
Enumeration date
01/14/2016
Last updated
01/14/2016
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