Individual
JESSICA NICOLE TALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
11909 ECHO POINT PL, CLARKSBURG, MD 20871-5335
(240) 405-4630
Mailing address
11909 ECHO POINT PL, CLARKSBURG, MD 20871-5335
(240) 405-4630
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
23164
MD
Other
Enumeration date
02/16/2018
Last updated
10/11/2022
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