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General NPI Number Information
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NPI Number | 1992530976
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Entity Type | Individual
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Provider Name | JASMINE LI
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Gender | Female
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Dates
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Enumeration Date | 09/07/2024
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Last Update Date | 09/07/2024
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Provider Practice Location Address
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Address Line | 1901 1ST AVE
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City | NEW YORK
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State | NY
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Zip | 10029-7494
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Country | US
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Telephone | 646-889-3036
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Fax |
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Provider Business Mailing Address
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Address Line | 24031 65TH AVE
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City | DOUGLASTON
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State | NY
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Zip | 11362-1920
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Country | US
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Telephone | 917-244-0113
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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 | 221700000X
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Taxonomy Name | Art Therapist
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License Number | P126359
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License Number State | NY
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