Individual
JAKARA HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1610 S MALCOLM X BLVD STE 320, DALLAS, TX 75226-2100
(409) 597-5673
Mailing address
608 S MCKINNEY ST, MEXIA, TX 76667-3644
(409) 597-5673
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
TX
Other
Enumeration date
01/29/2025
Last updated
01/29/2025
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