Provider Demographics
NPI:1922780949
Name:MCDUFFIE, JAZMINE TORIA
Entity Type:Individual
Prefix:MRS
First Name:JAZMINE
Middle Name:TORIA
Last Name:MCDUFFIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JAZMINE
Other - Middle Name:TORIA
Other - Last Name:DORSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 MAIN ST S
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-3914
Mailing Address - Country:US
Mailing Address - Phone:701-389-9363
Mailing Address - Fax:
Practice Address - Street 1:100 MAIN ST S
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-3914
Practice Address - Country:US
Practice Address - Phone:701-389-9363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDRBT-23-284443106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician