Provider Demographics
NPI:1073209623
Name:HENSON, ERIN RAE (OD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:RAE
Last Name:HENSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5694 ASHCROFT LN
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-8178
Mailing Address - Country:US
Mailing Address - Phone:614-886-8823
Mailing Address - Fax:
Practice Address - Street 1:142 W WATER ST STE L
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:OH
Practice Address - Zip Code:43449-1373
Practice Address - Country:US
Practice Address - Phone:419-898-1918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-17
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOPT.007150152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist