Most Relevant Information
Provider Data
| NPI Number: | 1003590399 |
| Provider Name: | LAVENIA HENDERSON |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/15/2023 |
| Last Updated: | 06/15/2023 |
Provider Practice Location
74 N ST SW
WASHINGTON
DC
200244127
Practice Location Phone/Fax
| Phone: | 2023779268 |
| Fax: |
Provider Mailing Location
74 N ST SW
WASHINGTON
DC
200244127
Provider Mailing Phone/Fax
| Phone: | 2023779268 |
| Fax: |