| Doctor Name: | MRS. MARY LEANORA HENRY |
| NPI Number: | 1215213244 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MAEDU |
| License Number: | 110000204444 |
| Business Practice Address: | 619 Houston St Spartanburg, SC - 293032135 |
| Business Phone Number: | 8649786439 |
| Business Fax Number: | |
| Mailing Address: | 619 Houston St, SPARTANBURG |
| State: | SC |
| Postal Code: | 293032135 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/21/2011 |
| NPI Last Update Date: | 10/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | 110000204444 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | SC |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |