Selena Jade Henderson

NPI #1194412460 in Elk River, Minnesota

Provider Information

NPI Number: 1194412460
Entity Type: Individual
Name: Selena Jade Henderson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Apr 18, 2023
Last Updated: Apr 18, 2023

Practice Location

Address: 19437 EVANS ST NW
City: Elk River
State: Minnesota
ZIP Code: 55330-1074
Phone: (763) 515-3532

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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