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1225310402
SUSAN K HENDERSON
SOUTH BEND, IN
NPI
1225310402
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IN 86000033A)
Enumeration Date
2011-09-14
Last Update Date
2011-09-14
Business Address
-- SUSAN K HENDERSON LAC
403 E MADISON ST
SOUTH BEND, IN 46617-2322
Phone number: 574-283-1234
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Mailing Address
-- SUSAN K HENDERSON LAC
PO BOX 809
GOSHEN, IN 46527-0809
Phone number: 574-533-1234
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