Individual
HOLLY JO HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
1701 TOWNSEND ST, CASSVILLE, MO 65625-1451
(417) 671-8075
Mailing address
PO BOX 221, CAPE FAIR, MO 65624-0221
(417) 559-0135
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2015002776
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811389620
—
MO
Enumeration date
03/03/2015
Last updated
04/09/2018
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