Individual
JASMIN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
207 MARDEN CT SE, SMYRNA, GA 30082-4335
(404) 915-1706
Mailing address
207 MARDEN CT SE, SMYRNA, GA 30082-4335
(404) 915-1706
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-80254
TN
106S00000X
Behavior Technician
RBT-21-151568
GA
Other
Enumeration date
03/06/2021
Last updated
03/31/2025
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