Individual
CAROLINE HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1745 W 82ND ST, LOS ANGELES, CA 90047-2738
(323) 633-2396
Mailing address
1745 W 82ND ST, LOS ANGELES, CA 90047-2738
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
363A00000X
Physician Assistant
Primary
—
CA
Other
Enumeration date
06/30/2015
Last updated
01/27/2025
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