Individual
JASMINE ARIEL GILLISPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1651 OLD MEADOW RD, MC LEAN, VA 22102-4311
(703) 506-0123
Mailing address
810 ROLLINS AVE, CAPITOL HEIGHTS, MD 20743-4342
(301) 318-6653
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/17/2018
Last updated
10/17/2018
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