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Individual

KIMBERLY FAITH HENDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NCC, LPC-MHSP (TEMP)

Contact information

Practice address
5128 JESSIE LEE LN, MEMPHIS, TN 38118-4521
(901) 290-8131
Mailing address
8360 EVEREST XING, SOUTHAVEN, MS 38672-6339

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5170
TN
101YP2500X
Professional Counselor
5170
TN

Other

Enumeration date
09/20/2021
Last updated
09/20/2021
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