Provider Demographics
NPI:1922385921
Name:ATKINS, JASMINE SIMONE (MS SLP CCC)
Entity type:Individual
Prefix:MS
First Name:JASMINE
Middle Name:SIMONE
Last Name:ATKINS
Suffix:
Gender:F
Credentials:MS SLP CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 E 217TH ST
Mailing Address - Street 2:APT# 1
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-5878
Mailing Address - Country:US
Mailing Address - Phone:718-926-7108
Mailing Address - Fax:
Practice Address - Street 1:733 E 217TH ST
Practice Address - Street 2:APT# 1
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-5878
Practice Address - Country:US
Practice Address - Phone:718-926-7108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015263235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist