Individual
JAMESE JEFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6545 CLUSTER PINE CT, WALDORF, MD 20603-6706
(240) 903-4339
Mailing address
6545 CLUSTER PINE CT, WALDORF, MD 20603-6706
(240) 903-4339
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
225C00000X
Rehabilitation Counselor
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
12/05/2018
Last updated
12/05/2018
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