| Susan T Henderson | |
|
1448 15th St Ste 203 Santa Monica CA 90404-2756 | |
| (310) 451-2107 | |
| (310) 451-9665 |
| Full Name | Susan T Henderson |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1448 15th St Ste 203, Santa Monica, California |
| Authorized Official Name and Position | Susan Trimble Henderson (OWNER SELF EMPLOYED) |
| Authorized Official Contact | 3104512107 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan T Henderson 1448 15th St Ste 203 Santa Monica CA 90404-2756 Ph: (310) 451-2107 | Susan T Henderson 1448 15th St Ste 203 Santa Monica CA 90404-2756 Ph: (310) 451-2107 |
| NPI Number | 1548324304 |
|---|---|
| Provider Enumeration Date | 12/19/2006 |
| Last Update Date | 11/08/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548324304 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCS9451 (California) | Primary |
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