Individual
DARRYL HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4776 ADAMS AVE, BATON ROUGE, LA 70802-1001
(225) 328-3328
Mailing address
4776 ADAMS AVE, BATON ROUGE, LA 70802-1001
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000
—
LA
Enumeration date
10/03/2017
Last updated
06/16/2018
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