Individual
JENA DAWN HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 21ST ST, CLOVIS, NM 88101
(505) 769-2345
Mailing address
916 AXTELL, APT B, CLOVIS, NM 88101
(505) 714-4084
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/25/2006
Last updated
07/08/2007
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