Healthcare Provider Details

I. General information

NPI: 1972925071
Provider Name (Legal Business Name): JHEANELLE HENRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2014
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2867 FOREST HILLS BLVD APT 7
CORAL SPRINGS FL
33065-5472
US

IV. Provider business mailing address

2867 FOREST HILLS BLVD APT 7
CORAL SPRINGS FL
33065-5472
US

V. Phone/Fax

Practice location:
  • Phone: 561-385-5969
  • Fax:
Mailing address:
  • Phone: 561-385-5969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: