Provider Demographics
NPI:1487521084
Name:HOLLSTEIN, JAYDON
Entity type:Individual
Prefix:
First Name:JAYDON
Middle Name:
Last Name:HOLLSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 SAWMILL PLACE BLVD APT 218
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-5209
Mailing Address - Country:US
Mailing Address - Phone:419-905-5040
Mailing Address - Fax:
Practice Address - Street 1:2760 AIRPORT DR STE 110
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-2284
Practice Address - Country:US
Practice Address - Phone:614-681-1030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1-25-84492103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst