Provider Demographics
NPI:1518785690
Name:HENSHAW, ERIN JANE (PHD)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:JANE
Last Name:HENSHAW
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3323 LOUDON ST
Mailing Address - Street 2:
Mailing Address - City:GRANVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43023-9758
Mailing Address - Country:US
Mailing Address - Phone:740-701-9888
Mailing Address - Fax:
Practice Address - Street 1:120 1/2 BROADWAY E
Practice Address - Street 2:
Practice Address - City:GRANVILLE
Practice Address - State:OH
Practice Address - Zip Code:43023-1304
Practice Address - Country:US
Practice Address - Phone:740-202-9042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-28
Last Update Date:2024-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.08698103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical