Individual
LATOYA L HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2224 JEROME BLVD, RACINE, WI 53403-3066
(262) 822-5298
Mailing address
2224 JEROME BLVD, RACINE, WI 53403-3066
(262) 822-5298
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
0019058
WI
Other
Enumeration date
02/27/2023
Last updated
02/27/2023
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