MS. Bethany Brooke Henderson

NPI #1588370001 in La Fayette, Georgia

Provider Information

NPI Number: 1588370001
Entity Type: Individual
Name: MS. Bethany Brooke Henderson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Jan 27, 2023
Last Updated: Jan 27, 2023

Practice Location

Address: 360 HAMMONTREE DR
City: La Fayette
State: Georgia
ZIP Code: 30728-5764
Phone: (423) 509-1650

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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