Individual
MS. JASMINE BRIANNA LANIQUE SHED-ACTWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6112 GOULD AVE S, SEATTLE, WA 98108-2959
(202) 780-6475
Mailing address
4615 S VIRGINIA ST APT 4H, AMARILLO, TX 79109-6042
(205) 566-4127
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/03/2025
Last updated
07/03/2025
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