Kyra Elise Henderson, MS
Speech-Language Pathologist, in Petaluma, CA. Individual provider (NPI-1).
NPI number1710558317
StatusActive
Last updated in NPPESJul 5, 2021
Details
- NPI
- 1710558317
- Entity type
- Individual (NPI-1)
- Name
- Kyra Elise Henderson
- Credential
- MS
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 5, 2021
- Certification date
- Jul 5, 2021
- Last updated
- Jul 5, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | – | – | Yes |
Practice location
1115 B StPetaluma, CA 94952-4028
Phone 707-765-3030
Mailing address
411 15th Ave Apt 21San Francisco, CA 94118-2827
Phone 714-296-6108
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All 36 Speech-Language Pathologist providers in Petaluma · All 2,210 providers in Petaluma
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