| Theresa M Henderson, Pa | |
|
1210 Millennium Pkwy Suite 1035 Brandon FL 33511-4861 | |
| (813) 716-0585 | |
| (813) 814-0448 |
| Full Name | Theresa M Henderson, Pa |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1210 Millennium Pkwy, Brandon, Florida |
| Authorized Official Name and Position | Theresa M Henderson (PRESIDENT) |
| Authorized Official Contact | 8137160585 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Theresa M Henderson, Pa 9609 Woodbay Dr Tampa FL 33626-2422 Ph: (813) 716-0585 | Theresa M Henderson, Pa 1210 Millennium Pkwy Suite 1035 Brandon FL 33511-4861 Ph: (813) 716-0585 |
| NPI Number | 1982979662 |
|---|---|
| Provider Enumeration Date | 03/14/2012 |
| Last Update Date | 03/28/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982979662 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW2072 (Florida) | Primary |
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