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Individual

JACK VALLEJO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW, LCSWC

Contact information

Practice address
1311 LONDONTOWN BLVD, SUITE # 130A, ELDERSBURG, MD 21784-6454
(410) 356-9200
(443) 200-0267
Mailing address
PO BOX 1229, SYKESVILLE, MD 21784-1229
(410) 356-9200
(443) 200-0267

Taxonomy

Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
07259
MD

Other

Enumeration date
08/04/2015
Last updated
08/04/2015
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