Individual
MS. DAPHNE HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1615 W 18TH ST, LORAIN, OH 44052-3919
(440) 246-6225
Mailing address
1615 W 18TH ST, LORAIN, OH 44052-3919
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN086504
OH
Other
Enumeration date
09/23/2009
Last updated
09/23/2009
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