Provider Demographics
NPI:1447748702
Name:JASMINE, JAUNELL NICHOLE
Entity Type:Individual
Prefix:
First Name:JAUNELL
Middle Name:NICHOLE
Last Name:JASMINE
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 1:931 WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-2400
Mailing Address - Country:US
Mailing Address - Phone:504-340-8880
Mailing Address - Fax:
Practice Address - Street 1:931 WESTWOOD DR
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-2400
Practice Address - Country:US
Practice Address - Phone:504-430-3174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst