Healthcare Provider Details

I. General information

NPI: 1083525653
Provider Name (Legal Business Name): JENNIFER LAYTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 N MAIN ST STE 101
BEL AIR MD
21014-8844
US

IV. Provider business mailing address

139 N MAIN ST STE 101
BEL AIR MD
21014-8844
US

V. Phone/Fax

Practice location:
  • Phone: 410-305-9825
  • Fax:
Mailing address:
  • Phone: 410-305-9825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number35514
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: