Individual
JO ANNA HENSON1
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2020 UA AVE SP 14, EMMETT, ID 83617
(208) 362-6273
Mailing address
2020 UA AVE SP 14, EMMETT, ID 83617
(208) 362-6273
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
ID
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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