| Doctor Name: | MS. RUTH ELAINE HENDERSON |
| NPI Number: | 1215145743 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FELLOW, AAPC |
| License Number: | |
| Business Practice Address: | 6512 Robar Tesora St Navarre, FL - 325668933 |
| Business Phone Number: | 3307014659 |
| Business Fax Number: | |
| Mailing Address: | 6512 Robar Tesora St, NAVARRE |
| State: | FL |
| Postal Code: | 325668933 |
| Phone Number: | 3307014659 |
| Fax Number: | |
| NPI Enumeration Date: | 05/18/2007 |
| NPI Last Update Date: | 11/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP1600X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Pastoral |
| Taxonomy Definition: | |