Individual
KISHA JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
7801 YORK RD, TOWSON, MD 21204-7446
(410) 847-7171
Mailing address
12530 S LAFLIN ST, CALUMET PARK, IL 60827-6004
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
06630
MD
Other
Enumeration date
07/18/2018
Last updated
06/11/2021
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