Individual
JASMINE TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
21 INDUSTRIAL PARK BLVD BLDG A, PONCHATOULA, LA 70454-8303
(985) 370-2300
Mailing address
PO BOX 2623, HAMMOND, LA 70404-2623
(985) 687-1118
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
541
LA
Other
Enumeration date
05/20/2021
Last updated
05/20/2021
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