Individual
DR. BILL LEE HENNINGS
Active
Individual
DR. BILL LEE HENNINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0614
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
064073000
REGENCE BC PROVIDER#
OR
01
—
110791
OMAP PROVIDER NUMBER
OR
01
—
1770574741
HEALTH NET
OR
01
—
559447
VALUE OPTIONS MHS#
OR
01
—
906669
SALEM HOSP MED STAFF ID #
OR
01
—
N54264777
UBH PROVIDER ID
OR
Enumeration date
10/31/2005
Last updated
12/23/2008
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