Provider Demographics
NPI:1417412149
Name:GOLDEN, JASMINE (RM, RM/T, EFT, CCSH)
Entity type:Individual
Prefix:MRS
First Name:JASMINE
Middle Name:
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:RM, RM/T, EFT, CCSH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6614 HAMPTON WAY DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-5533
Mailing Address - Country:US
Mailing Address - Phone:657-215-6152
Mailing Address - Fax:
Practice Address - Street 1:6614 HAMPTON WAY DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-5533
Practice Address - Country:US
Practice Address - Phone:657-215-6152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath