Individual
JACQUELINE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1215 49TH ST NE, WASHINGTON, DC 20019-3937
(202) 590-2153
Mailing address
1215 49TH ST NE, WASHINGTON, DC 20019-3937
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
70037597
—
DC
Enumeration date
04/04/2018
Last updated
04/04/2018
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