Individual
FAITH HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1742 MACKLIN ST NW, PALM BAY, FL 32907-8072
(321) 674-9884
Mailing address
1742 MACKLIN ST NW, PALM BAY, FL 32907-8072
(321) 674-9884
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
233884
FL
376J00000X
Homemaker
233884
FL
Other
Enumeration date
09/14/2016
Last updated
09/14/2016
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