JASMINE LATRIECE TILLMAN NPI 1275036162

NPI Information

  • NPI: 1275036162
  • Provider Name: JASMINE LATRIECE TILLMAN
  • Classification: Assistant Behavior Analyst - 106E00000X
  • Entity Type: Individual
  • Address: 19853 OUTER DR STE 110
    DEARBORN, MI
    ZIP 48124
  • Phone: (313) 406-5056

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NPI Details

Jasmine Latriece Tillman is an assistant behavior analyst in Dearborn, MI. The provider is an assistant behavior analyst is qualified by Behavior Analyst Certification Board certification and/or a state-issued license or credential in behavior analysis to practice under the supervision of an appropriately credentialed professional behavior analyst. An assistant behavior analyst delivers services consistent with the dimensions of applied behavior analysis and supervision requirements defined in state laws or regulations and/or national certification standards. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing behavior-analytic treatment plans, training and supervising others in implementation of components of treatment plans, and direct implementation of treatment plans. Jasmine Latriece Tillman NPI is 1275036162. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

19853 OUTER DR STE 110
DEARBORN, MI
ZIP 48124-044
Phone: (313) 406-5056
Fax: (248) 712-4381

The enumeration date for this NPI number is 3/16/2018 and was last updated on 6/10/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1106E00000XAssistant Behavior Analyst7402000124MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1386004894MEDICAIDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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