Individual
DR. SALLY JEAN HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D. LMFT LMSW
Contact information
Practice address
673 WESTBURY DRIVE, SUITE 201, IOWA CITY, IA 52245-2723
(319) 356-6352
(319) 358-2367
Mailing address
673 WESTBURY DRIVE, SUITE 201, IOWA CITY, IA 52245-2723
(319) 356-6352
(319) 358-2367
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
04884
IA
106H00000X
Marriage & Family Therapist
Primary
00142
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232194
MIDLANDS CHOICE CACTUS ID
IA
05
—
458268000
—
IA
Enumeration date
02/19/2007
Last updated
05/04/2011
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