Individual
JASMINE GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLPA
Contact information
Practice address
23101 LAKE CENTER DR, LAKE FOREST, CA 92630-2801
(949) 305-0315
Mailing address
34 MIRA MESA, RSM, CA 92688-3408
(949) 282-8298
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
07/19/2022
Last updated
07/19/2022
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