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NPI Code Detail

MEDICARE: JAZMINE SMITH

MEDICARE: JAZMINE SMITH
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1417770710
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAZMINE SMITH
Provider Business Mailing Address
First Line : 3700 MCKINNEY RANCH PKWY STE 300
Second Line :
City : MCKINNEY
State : TX
Zip : 75070-4717
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3700 MCKINNEY RANCH PKWY STE 300
Second Line :
City : MCKINNEY
State : TX
Zip : 75070-4717
Country : US
Telephone Number : 855-782-7822
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2024
Last Update Date : 11/05/2024

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Directions to “ JAZMINE SMITH ” Practice Location

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