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

Jered Devin Ethridge

Individual provider Behavior Technician · NPI 1407412174

Jered Devin Ethridge is a Behavior Technician in Poplar Bluff, Missouri. Registered with an NPI since 2019.

In the registry since
2019

Practice location Address checks out

2981 Kanell Blvd
Poplar Bluff, MO 63901-4008
Phone: (573) 712-2902
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 number1407412174
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 17, 2019
Last updated in NPPESMay 17, 2019
Mailing address2981 Kanell Blvd, Poplar Bluff, MO 63901-4008

Other providers in Poplar Bluff