Provider Demographics
NPI:1235880030
Name:HENDERSON, SCHAYELYNN RAE
Entity Type:Individual
Prefix:MS
First Name:SCHAYELYNN
Middle Name:RAE
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5741 OSUNA RD NE APT 500
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-2563
Mailing Address - Country:US
Mailing Address - Phone:505-258-9415
Mailing Address - Fax:
Practice Address - Street 1:5741 OSUNA RD NE APT 500
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-2563
Practice Address - Country:US
Practice Address - Phone:505-258-9415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician