Provider Demographics
NPI:1710332994
Name:EALES, JASMIN
Entity Type:Individual
Prefix:
First Name:JASMIN
Middle Name:
Last Name:EALES
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 1:5415 CONNECTICUT AVE NW
Mailing Address - Street 2:APT #341
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2765
Mailing Address - Country:US
Mailing Address - Phone:202-297-5416
Mailing Address - Fax:
Practice Address - Street 1:5415 CONNECTICUT AVE NW
Practice Address - Street 2:APT #341
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2765
Practice Address - Country:US
Practice Address - Phone:202-297-5416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker