Individual
JACK K HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS - CCC -SLP
Contact information
Practice address
2200 21ST AVE S STE 409, NASHVILLE, TN 37212-4929
(615) 669-2547
Mailing address
2200 21ST AVE S STE 409, NASHVILLE, TN 37212-4929
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0000005678
TN
Other
Enumeration date
04/22/2019
Last updated
01/09/2024
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