Provider Demographics
NPI:1295132165
Name:HENDERSON, NADENE (MS, LCGC)
Entity type:Individual
Prefix:
First Name:NADENE
Middle Name:
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:MS, LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 PENN AVENUE,
Mailing Address - Street 2:SUITE 1200, FACULTY PAVILION CHILDREN'S HOSPITAL OF PIT
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224
Mailing Address - Country:US
Mailing Address - Phone:412-692-6065
Mailing Address - Fax:412-692-7073
Practice Address - Street 1:4401 PENN AVE
Practice Address - Street 2:SUITE 1200, FACULTY PAVILION
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1334
Practice Address - Country:US
Practice Address - Phone:412-692-6065
Practice Address - Fax:412-692-7073
Is Sole Proprietor?:No
Enumeration Date:2014-11-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAGC000089170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS