Healthcare Provider Details

I. General information

NPI: 1376453597
Provider Name (Legal Business Name): JASMYN MARIE CELLA RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 BOARDWALK DR STE 490
FORT COLLINS CO
80525-3040
US

IV. Provider business mailing address

6881 S VERSAILLES WAY APT 15-206
AURORA CO
80016-5436
US

V. Phone/Fax

Practice location:
  • Phone: 888-904-9368
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-521080
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: