Individual
MRS. AMY HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, MS, LD
Contact information
Practice address
10306 N 138TH EAST AVE, SUITE 204, OWASSO, OK 74055-4665
(918) 401-0006
(877) 380-4628
Mailing address
5662 S 83RD EAST AVE, TULSA, OK 74145-7922
(918) 902-5611
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1719
OK
Other
Enumeration date
09/05/2014
Last updated
09/05/2014
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