Organization
THE EAGLES NEST FAMILY AND CHILDREN SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WANDA ELIZABETH JACKSON LCPC (EXECUTIVE DIRECTOR)
(443) 910-4797
Entity
Organization
Contact information
Practice address
900 A SOUTH MAIN STREET, SUITE 105, BEL AIR, MD 21014
(410) 914-4012
(410) 914-4013
Mailing address
4006 JEFFERY COURT, ABINGDON, MD 21009-3073
(443) 910-4797
(410) 515-0443
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC3588
MD
Other
Enumeration date
06/28/2011
Last updated
06/28/2011
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