NPI 1134830623

Ravanna Jackman-El

Practitioner Peer Specialist Baltimore, MD

Practice location

Address: 14 S Broadway, Baltimore, MD 21231-1712
Phone: (667) 234-0430

Registered specialties

Peer Specialist Primary

Other Service Providers Taxonomy 175T00000X Licence PR0584 (MD)

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Registry record

NPI: 1134830623
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Dec 2022
Record last updated: 6 Dec 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.