Individual
LASTACHIA HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
511 STERLINGTON HWY, FARMERVILLE, LA 71241-3122
(318) 309-1449
Mailing address
5425 HIGHWAY 33, MARION, LA 71260-3126
(646) 248-3852
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CIT-5671
LA
Other
Enumeration date
02/12/2024
Last updated
02/12/2024
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