Individual
MS. LATOYA MARIE HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2430 22ND ST NE, CANTON, OH 44705-2414
(330) 685-8179
Mailing address
2430 22ND ST NE, CANTON, OH 44705-2414
(330) 685-8179
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
252Y000000X
OH
Other
Enumeration date
02/06/2014
Last updated
02/06/2014
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