Individual
LAURA HENEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1107 E 66TH ST, SAVANNAH, GA 31404-5701
(707) 454-6791
(912) 350-5118
Mailing address
1107 E 66TH ST, SAVANNAH, GA 31404-5701
(707) 454-6791
(912) 350-5118
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1212626912
—
MI
Enumeration date
03/31/2021
Last updated
03/18/2024
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