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Individual

DR. JONATHAN MICHAEL LASSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
8 RESERVOIR CIR STE 103, BALTIMORE, MD 21208-6362
(443) 939-1195
Mailing address
6210 BENHURST RD, BALTIMORE, MD 21209-3807
(443) 939-1195

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
09/13/2012
Last updated
09/13/2012
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