Doctor Name: | ELAINE HENDERSON |
NPI Number: | 1548469182 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 3307 |
Business Practice Address: | 2865 E Main St Humboldt, TN - 383433070 |
Business Phone Number: | 7318240057 |
Business Fax Number: | |
Mailing Address: | 159 Mcmahan Ln, BATESVILLE |
State: | AR |
Postal Code: | 725018752 |
Phone Number: | 8706128411 |
Fax Number: | |
NPI Enumeration Date: | 07/13/2007 |
NPI Last Update Date: | 07/13/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 3307 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |