Provider Demographics
NPI:1003321787
Name:WRIGHT, JASMINE N (MS ED BCBA)
Entity Type:Individual
Prefix:MRS
First Name:JASMINE
Middle Name:N
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MS ED BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 FULTON AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-2210
Mailing Address - Country:US
Mailing Address - Phone:347-247-4070
Mailing Address - Fax:
Practice Address - Street 1:234 FULTON AVE FL 2
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305-2210
Practice Address - Country:US
Practice Address - Phone:347-247-4070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-04
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3853670174400000X
NJ1-19-38547103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No174400000XOther Service ProvidersSpecialist