Provider Demographics
NPI:1225158850
Name:HENSON, MARGARET JANE
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:JANE
Last Name:HENSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-6646
Mailing Address - Country:US
Mailing Address - Phone:901-529-4045
Mailing Address - Fax:901-529-4096
Practice Address - Street 1:1111 UNION AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-6646
Practice Address - Country:US
Practice Address - Phone:901-529-4045
Practice Address - Fax:901-529-4096
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1791225200000X
AR981225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant