Jackson Speedie, Mary L
Jackson Speedie, Mary L is an individual health care provider with primary practice located at 707 N Broadway , Baltimore MD 21205-1832. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as her primary health care specialty. Jackson Speedie, Mary L can be contacted via phone (443) 923-9200.Contact Information
Primary practice address
707 N Broadway
Baltimore MD 21205-1832
Phone: (443) 923-9200
Fax: (443) 923-9405
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | 01655 | Maryland |
Profile Details
| NPI number | 1396865218 |
|---|---|
| LBN Legal business name | Jackson Speedie, Mary L |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 2nd, 2007 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396865218 | NPPES |
| Maryland | Other | 36394001 | CAREFIRST BC BS |
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