MEDICARE: JASMYNE ALANE COLEMAN

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1841138351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMYNE ALANE COLEMAN

Provider Business Mailing Address
First Line	:	210 W BALTIMORE AVE APT 13
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-5055
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 W BALTIMORE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-5026
Country	:	US
Telephone Number	:	725-295-5150
Fax Number	:

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

Provider Enumeration Date	:	03/24/2026
Last Update Date	:	03/24/2026

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Directions to “ JASMYNE ALANE COLEMAN ” Practice Location

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