Individual
JASMINE STATEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 VALLEY ST, DAYTON, OH 45404-2070
(937) 641-3401
(937) 641-3046
Mailing address
PO BOX 933421, CLEVELAND, OH 44193-0039
(937) 641-5072
(937) 641-6129
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
P.08569
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0288064
—
OH
Enumeration date
02/07/2018
Last updated
04/02/2026
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