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1124118856
MARTHA LYNN HENSHAW
JACKSON, MS
NPI
1124118856
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2006-10-13
Last Update Date
2007-07-08
Business Address
-- MARTHA LYNN HENSHAW B.S.
1500 E WOODROW WILSON AVE
JACKSON, MS 39216-5116
Phone number: 601-364-1254
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Mailing Address
-- MARTHA LYNN HENSHAW B.S.
28 SANDWAY DR
BRANDON, MS 39042-2160
Phone number:
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