Individual
MRS. DELORES CLACK HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1615 MISTY FAWN LN, FRESNO, TX 77545-9502
(713) 410-0475
Mailing address
1615 MISTY FAWN LN, FRESNO, TX 77545-9502
(713) 410-0475
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT01206
TX
Other
Enumeration date
07/11/2013
Last updated
07/11/2013
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