Individual
DELEICE HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
2354 VICTORY AVE, TOLEDO, OH 43607-3544
(419) 984-6221
Mailing address
2354 VICTORY AVE, TOLEDO, OH 43607-3544
(419) 984-6221
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
10/19/2017
Last updated
10/19/2017
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