Individual
TYRA L HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4521 S EDGE RD, AYDEN, NC 28513-7119
(252) 864-1096
(252) 304-2103
Mailing address
4521 S EDGE RD, AYDEN, NC 28513-7119
(252) 864-1096
(252) 304-2103
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
03/26/2021
Last updated
03/26/2021
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