Individual
MS. JACKIE D HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7041 HEDGEBROOK DR, DALLAS, TX 75249
(972) 822-8115
Mailing address
7041 HEDGEBROOK DR, DALLAS, TX 75249
(972) 822-8115
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/07/2019
Last updated
09/07/2019
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