Individual
BRANDEE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1430 MAIN ST, WALTHAM, MA 02451-1623
(781) 647-5327
Mailing address
1430 MAIN ST, WALTHAM, MA 02451-1623
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042104356
—
MA
Enumeration date
08/03/2015
Last updated
08/03/2015
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