Jazmine L Church
Behavior Technician in Tampa, FL. Individual provider (NPI-1).
NPI number1104635440
StatusActive
Last updated in NPPESMar 12, 2026
Details
- NPI
- 1104635440
- Entity type
- Individual (NPI-1)
- Name
- Jazmine L Church
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 2, 2025
- Certification date
- Mar 12, 2026
- Last updated
- Mar 12, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | RBT-24-381960 | FL | Yes |
Practice location
11602 N 51st StTampa, FL 33617-2132
Phone 863-581-1583
Mailing address
Po Box 2112Lakeland, FL 33806-2112
Phone 863-581-1583 · Fax 863-644-9590
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