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NPI Code Detail

MEDICARE: ABIGAIL REESE HENDERSON

MEDICARE: ABIGAIL REESE HENDERSON
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
1235Z00000XSpeech-Language Pathologist308375KY

General Provider Information

NPI Number : 1790616944
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABIGAIL REESE HENDERSON
Provider Business Mailing Address
First Line : 1668 US HIGHWAY 68 E
Second Line :
City : BENTON
State : KY
Zip : 42025-7042
Country : US
Telephone Number : 270-443-5712
Fax Number : 270-933-1095
Provider Business Practice Location Address
First Line : 3235 OLIVET CHURCH RD STE D
Second Line :
City : PADUCAH
State : KY
Zip : 42001-9545
Country : US
Telephone Number : 270-443-5712
Fax Number : 270-933-1095
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2026
Last Update Date : 05/27/2026

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Directions to “ ABIGAIL REESE HENDERSON ” Practice Location

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