Healthcare Provider Details

I. General information

NPI: 1114088325
Provider Name (Legal Business Name): ANGELA DAWN HENSON P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 HAMILTON NEW LONDON RD
HAMILTON OH
45013-9461
US

IV. Provider business mailing address

1860 HAMILTON NEW LONDON RD
HAMILTON OH
45013-9461
US

V. Phone/Fax

Practice location:
  • Phone: 513-207-6102
  • Fax:
Mailing address:
  • Phone: 513-207-6102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4740
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: