Healthcare Provider Details

I. General information

NPI: 1528995578
Provider Name (Legal Business Name): JEWELS THERAPY CLINIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10839 PHILADELPHIA RD
WHITE MARSH MD
21162-1717
US

IV. Provider business mailing address

31 WALKER AVE
BALTIMORE MD
21208-4022
US

V. Phone/Fax

Practice location:
  • Phone: 410-415-3515
  • Fax:
Mailing address:
  • Phone: 410-415-3515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: JULES FUCHS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 410-415-3515