Doctor Name: | DR. MICHAEL RAY HENRY |
NPI Number: | 1043463714 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | LP3321 |
Business Practice Address: | 2261 Elm St Napa, CA - 945593721 |
Business Phone Number: | 7072598173 |
Business Fax Number: | |
Mailing Address: | Po Box 5235, 6271 Pleasants Valley Road VACAVILLE |
State: | CA |
Postal Code: | 956965235 |
Phone Number: | 8584496301 |
Fax Number: | |
NPI Enumeration Date: | 10/28/2008 |
NPI Last Update Date: | 01/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | LP3321 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |