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Diara Jackson
NPI 1407260870 · on the registry since 2014 · sole proprietor
Practice
- Address
- 4610 Furley Ave
Baltimore, MD 21206 - Phone
- (410) 929-2527
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Licence states on file
- MD
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2014-06-13
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Maryland