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:
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Health care specialties

SpecialtyCodeLicense #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 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154610152 NPPES
Tennessee MEDICAID Q057969

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