Staten, Jasmine
Staten, Jasmine is an individual health care provider with primary practice located at 1010 Valley St , Dayton OH 45404-2070. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as her primary health care specialty. Staten, Jasmine can be contacted via phone (937) 641-3401.Contact Information
Primary practice address
1010 Valley St
Dayton OH 45404-2070
Phone: (937) 641-3401
Fax: (937) 641-3046
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | P.08569 | Ohio |
Profile Details
| NPI number | 1578062261 |
|---|---|
| LBN Legal business name | Staten, Jasmine |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 7th, 2018 |
| Last updated | Dec 6th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578062261 | NPPES |
| Ohio | MEDICAID | 0288064 |
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