| Doctor Name: | MS. TERESA D HENDERSON |
| NPI Number: | 1174752364 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., LPEI |
| License Number: | 85-20EI |
| Business Practice Address: | 3117 Polk Road 44 Mena, AR - 719533891 |
| Business Phone Number: | 4792341808 |
| Business Fax Number: | 4792341808 |
| Mailing Address: | 3117 Polk Road 44, MENA |
| State: | AR |
| Postal Code: | 719533891 |
| Phone Number: | 4792341808 |
| Fax Number: | 4792341808 |
| NPI Enumeration Date: | 07/08/2009 |
| NPI Last Update Date: | 09/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | 85-20EI |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |