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Individual

MR. DARON GLEN HENDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
1285 NIXON AVE, IDAHO FALLS, ID 83404-5611
(208) 529-4300
Mailing address
1285 NIXON AVE, IDAHO FALLS, ID 83404-5611
(208) 529-4300

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-25799
ID

Other

Enumeration date
02/09/2007
Last updated
07/08/2007
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