Provider Demographics
NPI:1336922178
Name:SANCHEZ, JASMINE ARIELLE (MS, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:JASMINE
Middle Name:ARIELLE
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 SHADOWBROOK CT
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-5224
Mailing Address - Country:US
Mailing Address - Phone:630-656-0058
Mailing Address - Fax:
Practice Address - Street 1:2248 S MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-5258
Practice Address - Country:US
Practice Address - Phone:312-842-5083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-23-66668103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst