Most Relevant Information
Provider Data
| NPI Number: | 1003567066 |
| Provider Name: | JESSI COLL AA, ADT |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: | 2151 |
Most Important Dates
| Enumeration Date: | 01/12/2022 |
| Last Updated: | 01/12/2022 |
Provider Practice Location
3455 WILKENS AVE STE LL20
BALTIMORE
MD
212295203
Practice Location Phone/Fax
| Phone: | 4432788407 |
| Fax: |
Provider Mailing Location
3455 WILKENS AVE STE LL20
BALTIMORE
MD
212295203
Provider Mailing Phone/Fax
| Phone: | 4432788407 |
| Fax: |