Individual
EBONIE NICOLE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7100 SW HAMPTON ST STE 223, TIGARD, OR 97223-8364
(503) 342-2510
Mailing address
7100 SW HAMPTON ST STE 223, TIGARD, OR 97223-8364
(503) 342-2510
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C006788
NC
Other
Enumeration date
02/04/2008
Last updated
03/25/2024
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