Healthcare Provider Details

I. General information

NPI: 1255271425
Provider Name (Legal Business Name): JENNA PARSONS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13019 PAULINE DR
SHELBY TOWNSHIP MI
48315-3122
US

IV. Provider business mailing address

13019 PAULINE DR
SHELBY TOWNSHIP MI
48315-3122
US

V. Phone/Fax

Practice location:
  • Phone: 586-207-9255
  • Fax: 248-403-8500
Mailing address:
  • Phone: 586-207-9255
  • Fax: 248-403-8500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: