Jasmyne Star Gustafson

NPI #1801639919 in Anoka, Minnesota

Provider Information

NPI Number: 1801639919
Entity Type: Individual
Name: Jasmyne Star Gustafson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Jun 17, 2024
Last Updated: Jun 17, 2024

Practice Location

Address: 3401 ROUND LAKE BLVD NW
City: Anoka
State: Minnesota
ZIP Code: 55303-3315
Phone: (952) 247-3581

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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