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1902673668
DERRICK L HENDERSON
SHREVEPORT, LA
NPI
1902673668
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2023-12-04
Last Update Date
2023-12-04
Business Address
DERRICK L HENDERSON
3005 LONG PINES DR
SHREVEPORT, LA 71119-3412
Phone number: 318-572-6337
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Mailing Address
DERRICK L HENDERSON
3005 LONG PINES DR
SHREVEPORT, LA 71119-3412
Phone number: 318-572-6337
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