Individual
JASMINE VASICHEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2624 9TH AVE S, FARGO, ND 58103-2350
(701) 277-8844
Mailing address
647 13TH AVE E STE A, WEST FARGO, ND 58078-3328
(701) 277-8844
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
5817
ND
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/21/2017
Last updated
01/17/2020
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