Provider Demographics
NPI:1134703846
Name:OLIVER, JASMIN SADE (RBT)
Entity Type:Individual
Prefix:
First Name:JASMIN
Middle Name:SADE
Last Name:OLIVER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8114 APEX VW
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78244-1939
Mailing Address - Country:US
Mailing Address - Phone:210-517-3098
Mailing Address - Fax:
Practice Address - Street 1:8114 APEX VW
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78244-1939
Practice Address - Country:US
Practice Address - Phone:844-362-7943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-09
Last Update Date:2021-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician