Organization
JODI WAYNE, LCSW-C, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHANNA WAYNE LCSW-C (THERAPIST)
(443) 417-8011
Entity
Organization
Contact information
Practice address
336 S MAIN ST STE 2CA, BEL AIR, MD 21014-3978
(443) 417-8011
Mailing address
121 BRIARCLIFF LN, BEL AIR, MD 21014-5555
(443) 417-8011
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0347311
—
MD
Enumeration date
01/21/2019
Last updated
01/21/2019
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