Provider Demographics
NPI:1750045472
Name:SMITH, JASMINE SHARRON
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:SHARRON
Last Name:SMITH
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 1:765 E HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48505-4707
Mailing Address - Country:US
Mailing Address - Phone:810-233-5340
Mailing Address - Fax:
Practice Address - Street 1:765 E HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48505-4707
Practice Address - Country:US
Practice Address - Phone:810-233-5340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-28
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)