Individual
NAKEYIA LOUISE HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 WILSHIRE BLVD, LOS ANGELES, CA 90057-4303
(213) 380-9531
Mailing address
2500 WILSHIRE BLVD, LOS ANGELES, CA 90057-4303
(213) 380-9531
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
1568648590
CA
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
93979365A
—
CA
Enumeration date
10/15/2008
Last updated
10/15/2008
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