Individual
JASMINE ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
135 WARD ST APT 106, REVERE, MA 02151-1316
(617) 806-6821
Mailing address
135 WARD ST APT 106, REVERE, MA 02151-1316
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/23/2021
Last updated
11/23/2021
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