Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 02111848 | NC |
N | 106S00000X | Behavior Technician | RBT1745161 | FL |
N | 106S00000X | Behavior Technician | RBT1745161 | NC |
NPI | 1023550464 |
---|---|
Provider Name | Jasmelle Jaramillo-Mora |
First Address | Lilesville, NC 28091-7099 |
Second Address | Spring Lake, NC 28390-3316 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2016 |
Last Update Date | 22/04/2021 |