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General NPI Number Information
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NPI Number | 1497417018
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Entity Type | Individual
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Provider Name | MARY ANN HENSLEY ED.D., LPC, RPT
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Gender | Female
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Dates
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Enumeration Date | 10/11/2021
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Last Update Date | 10/11/2021
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Provider Practice Location Address
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Address Line | 11434 JASPER KAY TER UNIT 1114
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City | WINDERMERE
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State | FL
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Zip | 34786-5528
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Country | US
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Telephone | 706-459-7742
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Fax |
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Provider Business Mailing Address
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Address Line | 11434 JASPER KAY TER UNIT 1114
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City | WINDERMERE
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State | FL
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Zip | 34786-5528
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Country | US
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Telephone | 706-459-7742
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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 | LPC011422
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License Number State | GA
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