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Individual

JILL STANFORD-JICHA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
306 S MAIN ST, NORTH EAST, MD 21901-3916
(443) 207-2479
Mailing address
306 S MAIN ST, NORTH EAST, MD 21901-3916
(443) 207-2479

Taxonomy

Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary

Other

Enumeration date
06/03/2014
Last updated
06/03/2014
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