Individual
JASMINE BAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1802 S MATTIS AVE, CHAMPAIGN, IL 61821-5923
(217) 365-2855
Mailing address
611 W PARK ST, FAPC, URBANA, IL 61801-2500
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.104762
IL
Other
Enumeration date
11/21/2020
Last updated
03/15/2024
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