Individual
KEIARRA HENDRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
250 CHERRY RIDGE DR APT 1021, JACKSONVILLE, FL 32222
(904) 412-1904
Mailing address
250 CHERRY RIDGE DR APT 1021, JACKSONVILLE, FL 32222-2868
(904) 412-1904
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
Other
Enumeration date
05/07/2018
Last updated
07/26/2019
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