Individual
DERRICK L HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3005 LONG PINES DR, SHREVEPORT, LA 71119-3412
(318) 572-6337
Mailing address
3005 LONG PINES DR, SHREVEPORT, LA 71119-3412
(318) 572-6337
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
12/04/2023
Last updated
12/04/2023
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