Individual
JESSE FASK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2600 POT SPRING RD, VILA MARIA SCHOOL AT ST. VINCENTS, TIMONIUM, MD 21093-2732
(410) 252-3725
Mailing address
2600 POT SPRING RD, VILA MARIA SCHOOL AT ST. VINCENTS, TIMONIUM, MD 21093-2732
(410) 252-3725
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13392
MD
Other
Enumeration date
10/23/2008
Last updated
10/23/2008
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