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1396040077
SHELLY MARIE HENDERSON
COLBERT, WA
NPI
1396040077
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
320700000X Residential Treatment Facility, Physical Disabilities
(Licence: WA 249694)
Enumeration Date
2011-01-11
Last Update Date
2011-01-11
Business Address
-- SHELLY MARIE HENDERSON RMA
5612 E CARGILL LN
COLBERT, WA 99005-9110
Phone number: 509-238-4171
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Mailing Address
-- SHELLY MARIE HENDERSON RMA
5021 E CARGILL LN
COLBERT, WA 99005-9142
Phone number: 509-238-4171
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