Provider Demographics
NPI:1780321877
Name:JASMIN, KAREN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:JASMIN
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:PO BOX 736
Mailing Address - Street 2:
Mailing Address - City:RAY
Mailing Address - State:ND
Mailing Address - Zip Code:58849-0736
Mailing Address - Country:US
Mailing Address - Phone:701-568-8255
Mailing Address - Fax:701-568-8256
Practice Address - Street 1:22 2ND ST W
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-6055
Practice Address - Country:US
Practice Address - Phone:701-568-8255
Practice Address - Fax:701-568-8256
Is Sole Proprietor?:No
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2074235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist