Individual
SIMONE FAITH HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COSMETOLOGIST
Contact information
Practice address
11112 HULL STREET RD, MIDLOTHIAN, VA 23112-3204
(917) 834-1857
Mailing address
PO BOX 4552, MIDLOTHIAN, VA 23112-0010
(917) 834-1857
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
1201134889
VA
3747P1801X
Personal Care Attendant
22WE1157758
NY
Other
Enumeration date
11/07/2019
Last updated
11/07/2019
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