Individual
JADA HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1110 13TH ST, COLUMBUS, GA 31901-2246
(706) 780-1704
Mailing address
630 LEE ROAD 554, PHENIX CITY, AL 36867-0969
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/08/2019
Last updated
02/08/2019
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