TARYLL HENDERSON

SOUTH BEND, IN
NPI1689623969
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: IN  34004814A)
Enumeration Date2006-05-06
Last Update Date2007-07-08
Business Address
-- TARYLL HENDERSON LCSW
403 E MADISON ST
SOUTH BEND, IN 46617-2322
Phone number: 574-283-1107
Mailing Address
-- TARYLL HENDERSON LCSW
332 N WENGER AVE
MISHAWAKA, IN 46544-2522
Phone number: 574-259-1014