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Individual

MS. IVY DAMITA JERNIGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LCSW-C

Contact information

Practice address
401 HUNGERFORD DR, ROCKVILLE, MD 20850-4154
(240) 777-3048
Mailing address
7113 SANDOWN CIR, UNIT 201, WINDSOR MILL, MD 21244-8135
(443) 414-7044

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13602
MD

Other

Enumeration date
01/02/2014
Last updated
01/02/2014
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