Individual
JASMINE NORTHERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LBS
Contact information
Practice address
111 ELWYN RD, MEDIA, PA 19063-4622
(610) 891-2437
Mailing address
8309 WILLIAMS AVE, PHILADELPHIA, PA 19150-2022
(267) 474-1996
(267) 474-1996
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
BH006814
PA
Other
Enumeration date
04/15/2025
Last updated
04/15/2025
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