Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-20-43217 | GA |
N | 106S00000X | Behavior Technician |
NPI | 1003392051 |
---|---|
Provider Name | Jasmine Dionne |
First Address | Gainesville, FL 32607-3425 |
Second Address | Fayetteville, GA 30214-4056 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2018 |
Last Update Date | 11/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S | (05) | FL |