Individual
MRS. TRICIA MARIE HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., BCBA
Contact information
Practice address
4001 ROSEDALE PL, GROVETOWN, GA 30813-4897
(281) 543-5695
Mailing address
4001 ROSEDALE PL, GROVETOWN, GA 30813-4897
(281) 543-5695
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-10-6945
FL
Other
Enumeration date
08/04/2010
Last updated
10/20/2010
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