Individual
JASMINE BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8261 MARKET ST, BOARDMAN, OH 44512-6254
(330) 286-0050
Mailing address
8261 MARKET ST, BOARDMAN, OH 44512-6254
(330) 286-0050
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2647274
TRAVCO BEHAVIORAL HEALTH
OH
Enumeration date
12/07/2023
Last updated
12/07/2023
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