Provider Demographics
NPI:1336395193
Name:HENSON, FLORENCE MICHELLE (LPTA)
Entity Type:Individual
Prefix:MS
First Name:FLORENCE
Middle Name:MICHELLE
Last Name:HENSON
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:MRS
Other - First Name:FLORENCE
Other - Middle Name:MICHELLE
Other - Last Name:MONTANEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPTA
Mailing Address - Street 1:3051 WATSON BLVD
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093-8536
Mailing Address - Country:US
Mailing Address - Phone:478-953-7556
Mailing Address - Fax:478-953-4677
Practice Address - Street 1:3051 WATSON BLVD
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-8536
Practice Address - Country:US
Practice Address - Phone:478-953-7556
Practice Address - Fax:478-953-4677
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001343225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant