Provider Demographics
NPI:1376438275
Name:COLEMAN, JAZMINE N
Entity type:Individual
Prefix:
First Name:JAZMINE
Middle Name:N
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:597 WOODYARD RD
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:SC
Mailing Address - Zip Code:29847-2803
Mailing Address - Country:US
Mailing Address - Phone:803-522-0194
Mailing Address - Fax:803-522-0194
Practice Address - Street 1:7108 S KANNER HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-7462
Practice Address - Country:US
Practice Address - Phone:855-832-6727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician