Tiara Henderson
Contractor in Lakewood, OH. Individual provider (NPI-1).
NPI number1407487598
StatusActive
Last updated in NPPESJan 28, 2020
Details
- NPI
- 1407487598
- Entity type
- Individual (NPI-1)
- Name
- Tiara Henderson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 28, 2020
- Certification date
- Jan 28, 2020
- Last updated
- Jan 28, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171W00000X | Contractor | – | – | Yes |
Practice location
2040 Elbur AveLakewood, OH 44107-6114
Phone 216-972-3877
Mailing address
2040 Elbur AveLakewood, OH 44107-6114
Phone 216-972-3877
Other practice locations
4342 Lee Rd
Cleveland, OH 44128-2404
Cleveland, OH 44128-2404
Phone 216-972-3877
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