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General NPI Number Information
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NPI Number | 1073134607
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Entity Type | Individual
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Provider Name | DENA HENRY
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Gender | Female
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Dates
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Enumeration Date | 05/05/2020
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Last Update Date | 06/04/2020
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Provider Practice Location Address
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Address Line | 990 VILLA ST
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94041
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Country | US
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Telephone | 636-399-3375
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Fax |
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Provider Business Mailing Address
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Address Line | 16982 MANCHESTER RD UNIT 194
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City | WILDWOOD
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State | MO
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Zip | 63040-0150
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Country | US
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Telephone | 314-680-0867
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 2011013003
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License Number State | MO
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