Individual
MRS. MICHELLE HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 COURT ST SE STE 212, LIVE OAK, FL 32064-3203
(386) 209-7649
(386) 219-0222
Mailing address
424 MAPLE ST SW, LIVE OAK, FL 32064-3121
(386) 209-7649
(386) 219-0222
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
10/22/2018
Last updated
03/24/2025
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