Individual
BARBARA HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
223 BEAVER DAM RD, TUTWILER, MS 38963-5229
(662) 641-6835
(662) 757-9057
Mailing address
PO BOX 1001, CLEVELAND, MS 38732-1001
(662) 641-6835
(662) 757-9057
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81-0688451
—
MS
Enumeration date
03/09/2017
Last updated
03/09/2017
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