Provider Demographics
NPI:1447055819
Name:DAVIS, JASMINE JANELLE (RBT)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:JANELLE
Last Name:DAVIS
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5405 COLUMBIA RD APT 944
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-5726
Mailing Address - Country:US
Mailing Address - Phone:443-882-8047
Mailing Address - Fax:
Practice Address - Street 1:9140 GUILFORD RD STE 0
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1811
Practice Address - Country:US
Practice Address - Phone:443-538-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician