Provider Demographics
NPI:1699566406
Name:HENDERSON, LASHANTE P
Entity type:Individual
Prefix:MRS
First Name:LASHANTE
Middle Name:P
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4686 N CONGRESS AVE APT 107
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-3356
Mailing Address - Country:US
Mailing Address - Phone:561-670-8102
Mailing Address - Fax:
Practice Address - Street 1:4686 N CONGRESS AVE APT 107
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-3356
Practice Address - Country:US
Practice Address - Phone:561-670-8102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage