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Victoria Juanita Henderson

Counselor, Professional in Palos Heights, IL. Individual provider (NPI-1).

NPI number1790420719
StatusActive
Last updated in NPPESJun 14, 2022

Details

NPI
1790420719
Entity type
Individual (NPI-1)
Name
Victoria Juanita Henderson
Sex
Female
Sole proprietor
No
Enumeration date
May 3, 2022
Certification date
Jun 14, 2022
Last updated
Jun 14, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YP2500X Counselor, Professional––Yes
101YM0800X Counselor, Mental Health––

Practice location

12939 S Mason Ave
Palos Heights, IL 60463-2346

Phone 773-628-3250

Mailing address

12939 S Mason Ave
Palos Heights, IL 60463-2346

Phone 773-628-3250

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