Individual
IDA NATASHA HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2219 CLAIBORNE AVE, SHREVEPORT, LA 71103-4301
(318) 779-0434
(318) 210-0000
Mailing address
157 SUNVIEW LN, STONEWALL, LA 71078-8420
(318) 205-7977
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
16138
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
10/15/2020
Last updated
12/05/2023
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