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General NPI Number Information
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NPI Number | 1700377017
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Entity Type | Individual
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Provider Name | JASMINE BOSSIE LMT
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Gender | Female
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Dates
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Enumeration Date | 05/22/2018
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Last Update Date | 05/22/2018
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Provider Practice Location Address
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Address Line | 11100 PINION CT
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City | NORTH POTOMAC
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State | MD
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Zip | 20878-2565
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Country | US
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Telephone | 301-787-3192
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Fax |
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Provider Business Mailing Address
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Address Line | 11100 PINION CT
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City | NORTH POTOMAC
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State | MD
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Zip | 20878-2565
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Country | US
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Telephone | 301-787-3192
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | M05925
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT2389
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License Number State | DC
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