Individual
BREON MAREE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNC, MSN, CLC
Contact information
Practice address
510 CYPRESS ST, STE D, FORT BRAGG, CA 95437-5411
(707) 964-5696
(707) 964-6274
Mailing address
510 CYPRESS ST, STE D, FORT BRAGG, CA 95437-5411
(707) 964-5696
(707) 964-6274
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
95023758
CA
Other
Enumeration date
01/06/2017
Last updated
01/06/2017
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