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Organization
GUIDELINES COUNSELING PROGRAM
Active
Organization
GUIDELINES COUNSELING PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUE B JENKINS CCDC CAC AD MD (PROGRAM DIRECTOR OWNER)
(301) 846-0967
Entity
Organization
Contact information
Practice address
306 DELAWARE RD, FREDERICK, MD 21701
(301) 846-0967
(301) 846-0443
Mailing address
306 DELAWARE RD, FREDERICK, MD 21701
(301) 846-0967
(301) 846-0443
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101990
MD
Other
Enumeration date
08/05/2007
Last updated
08/05/2007
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