Individual
JESSICA GILLESPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 BOOTH ST, ELKTON, MD 21921-5657
(410) 996-5104
(410) 996-5725
Mailing address
4 YORKSHIRE CT, BEAR, DE 19701-3100
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
14033
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
922801200
—
MD
Enumeration date
06/10/2008
Last updated
06/10/2008
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