MEDICARE: JASMINE SANDERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1255814505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMINE SANDERS

Provider Business Mailing Address
First Line	:	7224 W CAMPUS RD
Second Line	:
City	:	NEW ALBANY
State	:	OH
Zip	:	43054-9122
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7224 W CAMPUS RD
Second Line	:
City	:	NEW ALBANY
State	:	OH
Zip	:	43054-9122
Country	:	US
Telephone Number	:	614-582-1937
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2018
Last Update Date	:	11/28/2023

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Directions to “ JASMINE SANDERS ” Practice Location

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