Provider Demographics
NPI:1295980670
Name:HENSLEY, AMY LATONIA (LMT)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:LATONIA
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2278 TRAWOOD DR.
Mailing Address - Street 2:STE. C
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935
Mailing Address - Country:US
Mailing Address - Phone:915-598-4433
Mailing Address - Fax:915-598-4437
Practice Address - Street 1:2278 TRAWOOD DR.
Practice Address - Street 2:STE. C
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935
Practice Address - Country:US
Practice Address - Phone:915-598-4433
Practice Address - Fax:915-598-4437
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT024485225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist