Individual
JESSICA AUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
839 BESTGATE RD, ANNAPOLIS, MD 21401-3472
(808) 292-8073
Mailing address
1739 WESTMORELAND TRL, ANNAPOLIS, MD 21401-6657
(808) 292-8073
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1312677
—
MA
01
—
685661
TUFTS
MA
01
—
M18708
BLUE CROSS
MA
Enumeration date
09/03/2008
Last updated
03/07/2014
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