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Individual

STACY RENEE HENSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MED, LPC

Contact information

Practice address
1414 N KENNEDY AVE STE 111, SHAWNEE, OK 74801-4761
(405) 878-7400
(405) 878-5558
Mailing address
PO BOX 280, PADEN, OK 74860-0280
(405) 826-5271

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3947
OK
103TS0200X
School Psychologist

Other

Enumeration date
04/08/2009
Last updated
12/01/2010
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