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Individual

ALICIA HENDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
55 FISHFRY ST, HARTFORD, CT 06120-1203
(860) 247-8300
Mailing address
71 CONGRESS ST, MANCHESTER, CT 06042-3018
(860) 948-8086

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
39162
CT

Other

Enumeration date
05/07/2021
Last updated
05/07/2021
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