Provider Demographics
NPI:1528394988
Name:HENSON, SUSAN E (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:HENSON
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16713 ROSCOE BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-6110
Mailing Address - Country:US
Mailing Address - Phone:800-861-3759
Mailing Address - Fax:800-861-3759
Practice Address - Street 1:100 E THOUSAND OAKS BLVD STE 228
Practice Address - Street 2:CORPORATE PLAZA I
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-5713
Practice Address - Country:US
Practice Address - Phone:800-418-9319
Practice Address - Fax:800-861-3759
Is Sole Proprietor?:No
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst