Provider Demographics
NPI:1497881668
Name:HENDERSON, ELIZABETH FRANCES (PT)
Entity Type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:FRANCES
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 SWEETBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3343
Mailing Address - Country:US
Mailing Address - Phone:318-445-3801
Mailing Address - Fax:
Practice Address - Street 1:91 TEXAS AVE STE C
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-5433
Practice Address - Country:US
Practice Address - Phone:318-715-1210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA00583225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist