MEDICARE: CHRISTINA HENDERSON BCBA

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	103K00000X	Behavior Analyst	3731	TX

General Provider Information

NPI Number	:	1851084032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA HENDERSON BCBA

Provider Business Mailing Address
First Line	:	724 HAVENCREST DR
Second Line	:
City	:	DESOTO
State	:	TX
Zip	:	75115-4618
Country	:	US
Telephone Number	:	469-337-3202
Fax Number	:

Provider Business Practice Location Address
First Line	:	1619 N HAMPTON RD
Second Line	:
City	:	DESOTO
State	:	TX
Zip	:	75115-2303
Country	:	US
Telephone Number	:	214-939-3933
Fax Number	:

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

Provider Enumeration Date	:	06/01/2023
Last Update Date	:	12/08/2025

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