Provider Demographics
NPI:1538573951
Name:HENDERSON, COURTNEY LAUREN (MOTR/L)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:LAUREN
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 LIVINGSTON ST STE 400
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4400
Mailing Address - Country:US
Mailing Address - Phone:828-505-0811
Mailing Address - Fax:828-505-1386
Practice Address - Street 1:60 LIVINGSTON ST STE 400
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4400
Practice Address - Country:US
Practice Address - Phone:828-505-0811
Practice Address - Fax:828-505-1386
Is Sole Proprietor?:No
Enumeration Date:2014-06-13
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCOT9248225X00000X
225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1538573951OtherNPI