Individual
JASON B DEITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
21001 GEORGIA AVE, BROOKEVILLE, MD 20833-1141
(301) 529-1127
Mailing address
21001 GEORGIA AVE, BROOKEVILLE, MD 20833-1141
(301) 529-1127
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/31/2022
Last updated
09/07/2022
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