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Individual

JARED HENDERSHOT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1001 LAURENCE AVE, JACKSON, MI 49202
(517) 750-4777
Mailing address
4370 CHICAGO DR SW STE 735, GRANDVILLE, MI 49418-1694

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
247200000X
Other Technician
Primary

Other

Enumeration date
07/06/2017
Last updated
03/11/2026
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