Individual
DR. LESLY JANE HENDERSHOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D., BCBA-D
Contact information
Practice address
30503 GREENFIELD RD, SOUTHFIELD, MI 48076-1594
(248) 691-4744
Mailing address
26901 BEAUMONT BLVD, SOUTHFIELD, MI 48033-3849
(947) 522-1867
(947) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
6301014875
MI
103TM1800X
Intellectual & Developmental Disabilities Psychologist
6301014875
MI
Other
Enumeration date
09/02/2009
Last updated
10/21/2020
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