Individual
SAMANTHA WILLETT-JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPAT, ATR-BC
Contact information
Practice address
8415 BELLONA LN, TOWSON, MD 21204-2055
(410) 357-1074
Mailing address
8415 BELLONA LN STE 104, TOWSON, MD 21204-2015
(410) 357-1074
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
221700000X
Art Therapist
23-568
—
221700000X
Art Therapist
ATC353
MD
Other
Enumeration date
11/24/2021
Last updated
03/17/2026
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