Provider Demographics
NPI:1255767554
Name:SNOW, JASMINE (MS)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:SNOW
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JASMINE
Other - Middle Name:
Other - Last Name:MABRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:2434 S EASON BLVD
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-6942
Mailing Address - Country:US
Mailing Address - Phone:662-640-4595
Mailing Address - Fax:662-680-6416
Practice Address - Street 1:2434 S EASON BLVD
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-6942
Practice Address - Country:US
Practice Address - Phone:662-640-4595
Practice Address - Fax:662-680-6416
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health