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1689623969
TARYLL HENDERSON
SOUTH BEND, IN
NPI
1689623969
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IN 34004814A)
Enumeration Date
2006-05-06
Last Update Date
2007-07-08
Business Address
-- TARYLL HENDERSON LCSW
403 E MADISON ST
SOUTH BEND, IN 46617-2322
Phone number: 574-283-1107
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Mailing Address
-- TARYLL HENDERSON LCSW
332 N WENGER AVE
MISHAWAKA, IN 46544-2522
Phone number: 574-259-1014
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