Individual
BRIANNA HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICDC
Contact information
Practice address
4977 NORTHCUTT PL, DAYTON, OH 45414-3839
(937) 387-6395
Mailing address
1566 W WAYNE ST, LIMA, OH 45805-2272
(419) 296-3330
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.2103248
OH
1041C0700X
Clinical Social Worker
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
341475943
—
OH
Enumeration date
04/23/2018
Last updated
03/01/2022
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