Individual
JASMINE PIERRA TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS ; BCBA
Contact information
Practice address
1356 BLUEGRASS LAKES PKWY, ALPHARETTA, GA 30004-3395
(833) 628-8476
(770) 200-1563
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-34729
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-21-53699
BCBA
GA
Enumeration date
05/02/2019
Last updated
03/01/2022
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