Individual
DEQUON DERICO HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 PELHAM RD STE 300, GREENVILLE, SC 29615-3354
(864) 203-8589
Mailing address
800 PELHAM RD STE 300, GREENVILLE, SC 29615-3354
(864) 203-8589
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB1276224
SC
Other
Enumeration date
05/06/2026
Last updated
05/06/2026
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