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Individual

TRACEY LYNETTE CAMPBELL HENDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
10000 N 31ST AVE STE C262, PHOENIX, AZ 85051-9630
(602) 754-0400
Mailing address
PO BOX 630164, NACOGDOCHES, TX 75963-0164
(936) 205-1875

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
1214661
TX

Other

Enumeration date
06/21/2017
Last updated
01/16/2026
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