Individual
MS. RODDIA JENNISE PAUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPA
Contact information
Practice address
3001 BRANCH AVE APT 616, HILLCREST HEIGHTS, MD 20748-1018
(202) 910-6109
Mailing address
3001 BRANCH AVE APT 616, HILLCREST HEIGHTS, MD 20748-1018
(202) 910-6109
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
A0666
MD
Other
Enumeration date
01/12/2021
Last updated
01/12/2021
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