IndividualActive
Autumn Henderson, M. ED
NPI 1477230795 · Developmental Therapist · Boise, ID
Provider details
- NPI number
- 1477230795
- Entity type
- Individual
- Primary specialty
- Developmental TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- M. ED
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
11632 W Santa Barbara Dr
Boise, ID 83709-6638
Phone: (208) 340-5677
Approximate (ZIP-level) locationGet directions
Mailing address
11632 W Santa Barbara Dr
Boise, ID 83709-6638
Registry dates
- Enumerated
- 2023-06-28
- Last updated
- 2023-06-28
- Certified
- 2023-06-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.