Individual
KYLA HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1608 5TH ST NW, ALBUQUERQUE, NM 87102-1302
(312) 882-0432
Mailing address
1827 N NATOMA AVE, CHICAGO, IL 60707-3919
(773) 495-0695
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SWB-2023-1102
NM
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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