Provider Demographics
NPI:1003539453
Name:HENDERSON, ARIEL PATRICE (RBT)
Entity Type:Individual
Prefix:MRS
First Name:ARIEL
Middle Name:PATRICE
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 TICONDEROGA DR
Mailing Address - Street 2:
Mailing Address - City:KEARNEYSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25430-2861
Mailing Address - Country:US
Mailing Address - Phone:757-752-9786
Mailing Address - Fax:
Practice Address - Street 1:8230 LEESBURG PIKE STE 740
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2641
Practice Address - Country:US
Practice Address - Phone:877-504-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician