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1295459964
LANITA HENDERSON
HATTIESBURG, MS
NPI
1295459964
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
373H00000X Day Training/Habilitation Specialist
(Licence: MS 0610)
Enumeration Date
2022-09-27
Last Update Date
2022-09-27
Business Address
LANITA HENDERSON CIDDT
41 BONHOMIE RD
HATTIESBURG, MS 39401-8648
Phone number: 601-450-0431
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Mailing Address
LANITA HENDERSON CIDDT
PO BOX 18679
HATTIESBURG, MS 39404-8679
Phone number: 601-705-1901
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