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Individual
LAKESHA DETARSETTA HENDERSON
Active
Individual
LAKESHA DETARSETTA HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
272668290
MENTAL HEALTH
LA
Enumeration date
01/11/2017
Last updated
01/11/2017
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