Individual
ANNA BLASETTI DEJONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCADC
Contact information
Practice address
1001 CATHEDRAL ST, BALTIMORE, MD 21201-5403
(410) 837-2050
(410) 837-7793
Mailing address
1001 CATHEDRAL ST, BALTIMORE, MD 21201-5403
(410) 837-2050
(410) 837-7793
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCA289
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132190100
—
MD
Enumeration date
07/25/2006
Last updated
05/21/2008
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