Individual
JADEN JUWAN FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4664 LARWELL DR, COLUMBUS, OH 43220-3621
(614) 487-7805
(614) 487-7809
Mailing address
1072 E 19TH AVE, COLUMBUS, OH 43211-2461
(614) 483-0576
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/23/2024
Last updated
08/23/2024
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