Healthcare Provider Details

I. General information

NPI: 1457273997
Provider Name (Legal Business Name): MAGIC HANDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8208 WELLINGTON PL
JESSUP MD
20794-8901
US

IV. Provider business mailing address

8208 WELLINGTON PL
JESSUP MD
20794-8901
US

V. Phone/Fax

Practice location:
  • Phone: 410-980-1347
  • Fax:
Mailing address:
  • Phone: 410-980-1347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANGELA JACKSON
Title or Position: OWNER
Credential:
Phone: 443-400-1497