Provider Demographics
NPI:1043828056
Name:HENSON, CASSI JO (HHA)
Entity type:Individual
Prefix:
First Name:CASSI
Middle Name:JO
Last Name:HENSON
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2041 BLACK RUN RD
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-8509
Mailing Address - Country:US
Mailing Address - Phone:740-542-2471
Mailing Address - Fax:
Practice Address - Street 1:2041 BLACK RUN RD
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-8509
Practice Address - Country:US
Practice Address - Phone:740-542-2471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty