| Doctor Name: | CAROL ANN HENDERSON |
| NPI Number: | 1013356955 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN-BC |
| License Number: | R130211 |
| Business Practice Address: | 4545 Crain Hwy # 1050 White Plains, MD - 206953045 |
| Business Phone Number: | 3016096728 |
| Business Fax Number: | 3016096741 |
| Mailing Address: | 4545 Crain Hwy, P.o. Box 1050 WHITE PLAINS |
| State: | MD |
| Postal Code: | 206953045 |
| Phone Number: | 3016096728 |
| Fax Number: | 3016096741 |
| NPI Enumeration Date: | 06/24/2013 |
| NPI Last Update Date: | 06/24/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | R130211 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |