Individual
CORY HENNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
32 BUCKTHORNE AVE, RIVERSIDE, RI 02915-3702
(401) 300-5549
Mailing address
555 N MAIN ST # 1156, PROVIDENCE, RI 02904-5722
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
ASW84452
CA
1041C0700X
Clinical Social Worker
Primary
LCSW108942
CA
Other
Enumeration date
07/02/2012
Last updated
02/25/2024
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