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General NPI Number Information
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NPI Number | 1770420291
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Entity Type | Individual
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Provider Name | JASMINE NICOLE ELHANNAOUI
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Gender | Female
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Dates
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Enumeration Date | 05/01/2026
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Last Update Date | 05/01/2026
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Provider Practice Location Address
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Address Line | 415 N RICHARD JACKSON BLVD
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32407-3664
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Country | US
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Telephone | 850-710-0741
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Fax |
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Provider Business Mailing Address
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Address Line | 6121 HARVEY ST APT 1
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City | CALLAWAY
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State | FL
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Zip | 32404-7553
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Country | US
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Telephone | 850-247-5517
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | BACB1565445
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License Number State | FL
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