Healthcare Provider Details

I. General information

NPI: 1487390159
Provider Name (Legal Business Name): JASMIN HARVEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2022
Last Update Date: 06/08/2022
Certification Date: 06/08/2022
Deactivation Date: 05/06/2022
Reactivation Date: 06/08/2022

III. Provider practice location address

2 LOGAN SQ STE 300
PHILADELPHIA PA
19103-2733
US

IV. Provider business mailing address

2 LOGAN SQ STE 300
PHILADELPHIA PA
19103-2733
US

V. Phone/Fax

Practice location:
  • Phone: 888-922-2843
  • Fax: 855-568-2494
Mailing address:
  • Phone: 888-922-2843
  • Fax: 855-568-2494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: