Healthcare Provider Details

I. General information

NPI: 1922692151
Provider Name (Legal Business Name): JODI LEVONNE ALBRIGHT MA, MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2021
Last Update Date: 08/08/2022
Certification Date: 12/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6002 LOTTIE PL
CLINTON MD
20735-1533
US

IV. Provider business mailing address

6002 LOTTIE PL
CLINTON MD
20735-1533
US

V. Phone/Fax

Practice location:
  • Phone: 301-806-7503
  • Fax:
Mailing address:
  • Phone: 301-806-7503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number15539
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: