Individual
JASMINE SORRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 9736, MISSISSIPPI STATE, MS 39762-9736
(662) 325-1028
Mailing address
PO BOX 9736, MISSISSIPPI STATE, MS 39762-9736
(662) 292-2426
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
241021
MS
Other
Enumeration date
05/08/2023
Last updated
11/14/2024
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