Provider Demographics
NPI:1730288739
Name:HENSON, NONA ANNE (MFTI)
Entity Type:Individual
Prefix:MRS
First Name:NONA
Middle Name:ANNE
Last Name:HENSON
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:MS
Other - First Name:NONA
Other - Middle Name:ANNE
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFTI
Mailing Address - Street 1:9412 BIG HORN BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-1101
Mailing Address - Country:US
Mailing Address - Phone:916-893-9596
Mailing Address - Fax:916-226-2804
Practice Address - Street 1:9412 BIG HORN BLVD STE 6
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-1101
Practice Address - Country:US
Practice Address - Phone:916-893-9596
Practice Address - Fax:916-226-2804
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFTI 71866106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist