Individual
BRENT N HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5115 CENTRE AVE, SUITE 140, PITTSBURGH, PA 15232-1301
(412) 623-5888
(412) 623-5980
Mailing address
2 HOT METAL ST, QUANTUM ONE, N430, PITTSBURGH, PA 15203-2348
(412) 432-7706
(412) 432-7691
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS015211
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001905341
—
PA
01
—
11440288
CAQH
PA
05
—
520447
—
PA
Enumeration date
01/27/2006
Last updated
07/28/2009
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