Individual
CARLOS HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
15910 MIDLAND AVE, 2ND FLOOR, CLEVELAND, OH 44110-2425
(216) 249-4038
Mailing address
15910 MIDLAND AVE, 2ND FLOOR, CLEVELAND, OH 44110-2425
(216) 249-4038
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.359480
OH
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN.359480
OH
Other
Enumeration date
12/12/2010
Last updated
12/12/2010
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