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General NPI Number Information
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NPI Number | 1700119468
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Entity Type | Individual
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Provider Name | JASMIN TANJELOFF TERRANY EDM, MA, LMHC
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Gender | Female
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Dates
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Enumeration Date | 09/14/2009
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Last Update Date | 02/18/2013
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Provider Practice Location Address
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Address Line | 17201 COLLINS AVE APT 1201
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City | SUNNY ISLES BEACH
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State | FL
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Zip | 33160-3477
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Country | US
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Telephone | 646-496-5299
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Fax |
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Provider Business Mailing Address
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Address Line | 17201 COLLINS AVE APT 1201
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City | SUNNY ISLES BEACH
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State | FL
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Zip | 33160-3477
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Country | US
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Telephone | 646-496-5299
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH10944
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0044541
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License Number State | NY
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