| NPI | 1205185329 |
|---|---|
| Former Name | ALICE JEAN HENDERSHOTT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0056202) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL UO3114) |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2022-07-21 |