Individual
MS. SHONQUELL S HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6637 N 18TH ST, PHILADELPHIA, PA 19126-2618
(267) 257-9386
Mailing address
2418 N DOUGLAS ST, PHILADELPHIA, PA 19132-3318
(267) 257-9386
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
12/05/2018
Last updated
12/05/2018
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