Individual
JASMINE TIERRA LACHE WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10003 RUFFIAN WAY STE B, LAUREL, MD 20723-2088
(240) 706-0748
Mailing address
10003 RUFFIAN WAY STE B, LAUREL, MD 20723-2088
(240) 706-0748
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
24969
MD
1041C0700X
Clinical Social Worker
Primary
24969
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38-3876389
—
MD
Enumeration date
06/05/2019
Last updated
03/08/2023
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