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General NPI Number Information
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NPI Number | 1508429358
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Entity Type | Individual
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Provider Name | CASARAH HENDERSON M.S.
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Gender | Female
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Dates
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Enumeration Date | 04/17/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 1060 W STATE ROAD 434
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City | LONGWOOD
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State | FL
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Zip | 32750-4919
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Country | US
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Telephone | 407-307-5336
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Fax |
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Provider Business Mailing Address
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Address Line | 800 POLK ST
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City | ORLANDO
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State | FL
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Zip | 32805-1637
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Country | US
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Telephone | 321-999-6382
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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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