Individual
MS. JASMIN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGPC
Contact information
Practice address
21 INDUSTRIAL PARK DR STE 104D, WALDORF, MD 20602-2751
(301) 818-0030
Mailing address
185 ADMIRAL COCHRANE DR STE 120, ANNAPOLIS, MD 21401-7600
(443) 440-5780
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LGP9796
MD
Other
Enumeration date
01/20/2020
Last updated
01/20/2020
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