Individual
DEASIA DIAZ HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1001 JOHNSON FERRY RD, ATLANTA, GA 30342-1605
(404) 785-2273
(404) 785-9168
Mailing address
11350 MCCORMICK ROAD, EP1, SUITE 501, HUNT VALLEY, MD 21031
(410) 329-1071
(410) 329-1054
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10810
GA
363A00000X
Physician Assistant
C0006922
MD
Other
Enumeration date
09/28/2018
Last updated
07/25/2025
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