Provider Demographics
NPI:1417691148
Name:LINDSAY, JASMINE (RBT)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:LINDSAY
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 1:704 GREAT OAK PL
Mailing Address - Street 2:
Mailing Address - City:VILLA RICA
Mailing Address - State:GA
Mailing Address - Zip Code:30180-2535
Mailing Address - Country:US
Mailing Address - Phone:678-477-1431
Mailing Address - Fax:
Practice Address - Street 1:704 GREAT OAK PL
Practice Address - Street 2:
Practice Address - City:VILLA RICA
Practice Address - State:GA
Practice Address - Zip Code:30180-2535
Practice Address - Country:US
Practice Address - Phone:678-477-1431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician