Most Relevant Information
Provider Data
| NPI Number: | 1003214339 |
| Provider Name: | SCOTT HENDERSON |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/18/2014 |
| Last Updated: | 12/18/2014 |
Provider Practice Location
259 BILL FRANCE BLVD STE 200
DAYTONA BEACH
FL
321141316
Practice Location Phone/Fax
| Phone: | 3868681992 |
| Fax: |
Provider Mailing Location
452 ISLAND VIEW CIR
ST AUGUSTINE
FL
320959631
Provider Mailing Phone/Fax
| Phone: | 9042406209 |
| Fax: |