Individual
MR. JASON ROBERT PHELAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA-ADP
Contact information
Practice address
975 SOLOMONS ISLAND RD N, PRINCE FREDERICK, MD 20678-3917
(410) 535-3079
(410) 535-2220
Mailing address
PO BOX 1158, PRINCE FREDERICK, MD 20678-1158
(410) 535-3079
(410) 535-2220
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/30/2014
Last updated
01/30/2014
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