Provider Demographics
NPI:1225500614
Name:WASHINGTON, JASMINE R (BCBA)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:R
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 EMPIRE DR APT 6319
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-0081
Mailing Address - Country:US
Mailing Address - Phone:225-323-4456
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:919 MEDICAL DR STE 1200
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-5756
Practice Address - Country:US
Practice Address - Phone:972-217-4110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-22
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA106S00000X
TX1-22-61797103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician