Individual
JAYDEN HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13101 ALLEN RD, SOUTHGATE, MI 48195-2216
(734) 785-7700
Mailing address
44670 ANN ARBOR RD W, PLYMOUTH, MI 48170-3962
(313) 278-4601
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/26/2020
Last updated
12/27/2023
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