Individual
DEWANNA HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C, BA
Contact information
Practice address
305 S BENEDICT AVE, OAK RIDGE, TN 37830-7310
(865) 685-0022
Mailing address
5729 LEBANON RD, STE 144-425, FRISCO, TX 75034-7260
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
TX
363A00000X
Physician Assistant
2315
TN
363A00000X
Physician Assistant
7034
GA
Other
Enumeration date
02/10/2013
Last updated
01/17/2017
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