Individual
MRS. DEANDRA RENEE HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1070 HILLSTONE RD, CLEVELAND HEIGHTS, OH 44121-2473
(216) 835-1724
Mailing address
1070 HILLSTONE RD, CLEVELAND HEIGHTS, OH 44121-2473
(216) 835-1724
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN125915
OH
Other
Enumeration date
09/26/2011
Last updated
09/26/2011
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