Healthcare Provider Details

I. General information

NPI: 1841940954
Provider Name (Legal Business Name): DANIELLE HENDERSON BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6828 LACKMAN RD
SHAWNEE KS
66217-9595
US

IV. Provider business mailing address

1316 E 101ST ST
KANSAS CITY MO
64131-3314
US

V. Phone/Fax

Practice location:
  • Phone: 913-608-7355
  • Fax: 866-308-0972
Mailing address:
  • Phone: 309-224-8859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number00507
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: