Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 63170 | TX |
NPI | 1003360546 |
---|---|
Provider Name | Mrs. Rachel Hall Henning |
First Address | Mansfield, TX 76063-3201 |
Second Address | Mansfield, TX 76063-3201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2016 |
Last Update Date | 13/08/2016 |