Healthcare Provider Details

I. General information

NPI: 1134063290
Provider Name (Legal Business Name): JAYLIN SIERRA COLLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9030 RED BRANCH RD STE 100
COLUMBIA MD
21045-2003
US

IV. Provider business mailing address

2213 WESTWOOD AVE
BALTIMORE MD
21216-3726
US

V. Phone/Fax

Practice location:
  • Phone: 877-504-4141
  • Fax:
Mailing address:
  • Phone: 443-707-7134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: