Individual
MR. DWAYNE ELVON JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2015 MARTINS GRANT CT, CROWNSVILLE, MD 21032-1932
(410) 721-6353
(410) 721-2071
Mailing address
2015 MARTINS GRANT CT, CROWNSVILLE, MD 21032-1932
(410) 721-6353
(410) 721-2071
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
SC0671
MD
Other
Enumeration date
02/28/2018
Last updated
02/28/2018
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