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General NPI Number Information
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NPI Number | 1316672322
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Entity Type | Individual
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Provider Name | JASMINE ANTHONY LMSW
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Gender | Female
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Dates
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Enumeration Date | 07/22/2022
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Last Update Date | 11/09/2022
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Provider Practice Location Address
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Address Line | 1140 BLADES FARM RD STE 202
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City | DENTON
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State | MD
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Zip | 21629-3489
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Country | US
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Telephone | 410-204-4554
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Fax |
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Provider Business Mailing Address
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Address Line | 1140 BLADES FARM RD
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City | DENTON
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State | MD
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Zip | 21629-3488
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Country | US
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Telephone | 302-519-3130
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 28719
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 28719
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License Number State | MD
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