MEDICARE: HALIE HENSHAW M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SZ9757	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245845957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALIE HENSHAW M.S.

Provider Business Mailing Address
First Line	:	2001 SABAL RIDGE CT APT E
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-8922
Country	:	US
Telephone Number	:	561-308-6076
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 SABAL RIDGE CT APT E
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-8922
Country	:	US
Telephone Number	:	561-308-6076
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2020
Last Update Date	:	09/10/2020

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Directions to “ HALIE HENSHAW M.S.” Practice Location

Language	Start Address	Practice Location

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