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General NPI Number Information
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NPI Number | 1215533401
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Entity Type | Individual
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Provider Name | JASMINE MONIQUE HARDING
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Gender | Female
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Dates
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Enumeration Date | 12/11/2020
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Last Update Date | 12/11/2020
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Provider Practice Location Address
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Address Line | 1100 9TH ST STE D
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City | VIENNA
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State | WV
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Zip | 26105-2176
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Country | US
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Telephone | 304-428-6148
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Fax |
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Provider Business Mailing Address
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Address Line | 661 E MAPLE ST
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City | DAVISVILLE
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State | WV
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Zip | 26142-8812
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Country | US
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Telephone | 740-319-6482
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | TY79569
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License Number State | OH
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