Henderson, Joletta Kemp
Henderson, Joletta Kemp is an sole proprietor health care provider with primary practice located at 6393 Green Grove Dr , Memphis TN 38141-7158. She recently has 3 registered licenses in different health care specialties including Other Service Providers / Contractor, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, Other Service Providers / Home Modifications. Other Service Providers / Home Modifications is her primary health care specialty. Henderson, Joletta Kemp can be contacted via phone (901) 282-7738.Contact Information
Primary practice address
6393 Green Grove Dr
Memphis TN 38141-7158
Phone: (901) 282-7738
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Other Service Providers / Contractor | 171W00000X | 64592 | Tennessee |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant | 225200000X | PTA 1579 | Arkansas |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant | 225200000X | PTA4329 | Mississippi |
Other Service Providers / Home Modifications | 171WH0202X | 64592 | Tennessee |
Profile Details
NPI number | 1154610152 |
---|---|
LBN Legal business name | Henderson, Joletta Kemp |
Credentials | |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Mar 31st, 2011 |
Last updated | Aug 17th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1154610152 | NPPES |
Tennessee | MEDICAID | Q057969 |
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