Provider Demographics
NPI:1730998568
Name:HENRIQUEZ, JUANA FELIPA
Entity type:Individual
Prefix:
First Name:JUANA
Middle Name:FELIPA
Last Name:HENRIQUEZ
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 1:4301 REX RD
Mailing Address - Street 2:
Mailing Address - City:REX
Mailing Address - State:GA
Mailing Address - Zip Code:30273-1429
Mailing Address - Country:US
Mailing Address - Phone:678-933-8917
Mailing Address - Fax:
Practice Address - Street 1:4301 REX RD
Practice Address - Street 2:
Practice Address - City:REX
Practice Address - State:GA
Practice Address - Zip Code:30273-1429
Practice Address - Country:US
Practice Address - Phone:678-933-8917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter