Doctor Name: | MRS. JESSICA HENDERSON |
NPI Number: | 1790154524 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MT121981 |
License Number: | MT1211981 |
Business Practice Address: | 6010 Balcones Dr Ste 260 Austin, TX - 787314294 |
Business Phone Number: | 5129035256 |
Business Fax Number: | |
Mailing Address: | 6010 Balcones Dr Ste 260, AUSTIN |
State: | TX |
Postal Code: | 787314294 |
Phone Number: | 5129035256 |
Fax Number: | |
NPI Enumeration Date: | 09/22/2015 |
NPI Last Update Date: | 09/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MT1211981 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |