Jeremy Hagerman
Individual provider Active NPI Behavior Technician · Lennon, MI
NPI 1912414905 · NPPES record last updated Feb 22, 2019
Key facts
- NPI
- 1912414905
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 11410 E Lennon Rd
Lennon, MI 48449-9666 - Phone
- (810) 621-4721
- NPI assigned
- Dec 29, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Labaza Eyecare, P.C. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | |||
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
11410 E Lennon Rd
Lennon, MI 48449-9666
Mailing address
27777 Inkster Rd Ste 100
Farmington Hills, MI 48334-5326
Phone (248) 299-0030
Other providers in Lennon, MI
- Kayla Sue Farley
- Tiffany Renee Fernandez
- Lateka Fleming
- Dakotah Daniel Frey
- Rick Galloway
- Samantha Ann Hagerman
- Louanne Hammond
- Dawn Marie Hawley
- Madalynn Hensel
- Cindi Lou Hokanson
All providers in Lennon, MI · Behavior Technician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.