Healthcare Provider Details

I. General information

NPI: 1326965799
Provider Name (Legal Business Name): KATERINA JOJIC ADT3779
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3455 WILKENS AVE
BALTIMORE MD
21229-5213
US

IV. Provider business mailing address

3455 WILKENS AVE
BALTIMORE MD
21229-5213
US

V. Phone/Fax

Practice location:
  • Phone: 410-646-6970
  • Fax: 410-644-5609
Mailing address:
  • Phone: 410-646-6970
  • Fax: 410-644-5609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberADT3779
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: