Provider Demographics
NPI:1891577367
Name:HENSON, ROBERT DEE I
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:DEE
Last Name:HENSON
Suffix:I
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 1:26170 BENTON AVE # 0
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-2514
Mailing Address - Country:US
Mailing Address - Phone:216-924-9342
Mailing Address - Fax:
Practice Address - Street 1:26170 BENTON AVE # 0
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-2514
Practice Address - Country:US
Practice Address - Phone:216-924-9342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst