Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jack Ryan Henderson

Individual provider Behavior Technician · NPI 1477203164

Jack Ryan Henderson is a Behavior Technician in Boulder, Colorado. Registered with an NPI since 2022.

In the registry since
2022

Practice location Address checks out

4770 Baseline Rd Ste 200
Boulder, CO 80303-2668
Phone: (970) 982-3476
Fax: (855) 568-2494
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X

Record details

NPI number1477203164
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 25, 2022
Last updated in NPPESMarch 25, 2022
Certification dateMarch 25, 2022
Mailing address4770 Baseline Rd Ste 200, Boulder, CO 80303-2668

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