Individual
PHAEDRA HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
32 S MACDONALD, MESA, AZ 85210-1310
(480) 969-1471
(480) 269-9426
Mailing address
32 S MACDONALD, MESA, AZ 85210-1310
(480) 969-1471
(480) 269-9426
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/19/2015
Last updated
09/19/2015
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