| Doctor Name: | JOSH HENDERSON |
| NPI Number: | 1043458979 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | APC002190 |
| Business Practice Address: | 700 City Hall Dr Fort Oglethorpe, GA - 307427802 |
| Business Phone Number: | 4233643460 |
| Business Fax Number: | 7066385541 |
| Mailing Address: | 700 City Hall Dr, FORT OGLETHORPE |
| State: | GA |
| Postal Code: | 307427802 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/30/2009 |
| NPI Last Update Date: | 01/30/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | APC002190 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |