Individual
LISA WRICE-HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NEMT
Contact information
Practice address
259 TAHO CIR, VALRICO, FL 33594-3556
(614) 226-1939
Mailing address
PO BOX 1014, VALRICO, FL 33595-1014
(813) 658-8759
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
92270586172208
FL
Other
Enumeration date
04/11/2023
Last updated
04/11/2023
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