Individual
JASMINA JOAN NYSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6570 SOSNA DR, FAIRFIELD, OH 45014-2222
(513) 942-4673
Mailing address
5457 SOUTHGATE BLVD APT 1, FAIRFIELD, OH 45014-3447
(941) 815-2859
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/22/2020
Last updated
05/22/2020
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