person
Jimmy Douglas II
Professional Counselor in Columbia, Maryland
NPI 1831670405

Jimmy Douglas II is a Professional Counselor based in Columbia, MD and is specialized in Professional. Jimmy Douglas II practices in Columbia, MD. The NPI Number for Jimmy Douglas II is 1831670405 and holds a License No. LGP8560 (Maryland).

The current practice location address for Jimmy Douglas II is 9191 Carriage House Ln, Columbia, MD and can be reached out via phone at 512-554-4375.

Location: 9191 Carriage House Ln, Columbia, MD, 21045-4077
person
Provider Profile Details
NPI Number
1831670405
Provider Name
Jimmy Douglas II
Credential
Provider Entity Type
Individual
Gender
Male
Address
9191 Carriage House Ln, Columbia, MD, 21045-4077
Phone Number
512-554-4375
Fax Number
Provider Enumeration Date
08/22/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
38-3876389 05 MD
institution
Provider Business Practice Location Address Details
Address
9191 Carriage House Ln
City
State
Zip
21045-4077
Phone Number
512-554-4375
Fax Number
person
Provider Business Mailing Address Details
Address
9191 Carriage House Ln
City
State
Zip
21045-4077
Phone Number
512-554-4375
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
LGP8560 (Maryland)
Definition
Definition to come...
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