Individual
MS. KEISHA MARIE HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
WLS, CWC
Contact information
Practice address
3330 CUMBERLAND BLVD SE STE 500, ATLANTA, GA 30339-5997
(678) 242-9239
(770) 933-6223
Mailing address
1309 ADCOX SQ, STONE MOUNTAIN, GA 30088-4544
(321) 460-9429
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
GA
Other
Enumeration date
10/30/2017
Last updated
10/30/2017
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