Individual
MARION ROBERT HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
409 SIMPKINS ST, EDGEFIELD, SC 29824-1313
(803) 637-5338
(803) 637-0753
Mailing address
1547 PARKWAY, SUITE100, GREENWOOD, SC 29646-4081
(864) 229-7120
(864) 229-5526
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
421504
—
SC
Enumeration date
09/28/2006
Last updated
07/08/2007
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