Provider Demographics
NPI:1063866226
Name:JAMISON, YASEMIN AYLIN (LMT)
Entity Type:Individual
Prefix:MRS
First Name:YASEMIN
Middle Name:AYLIN
Last Name:JAMISON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 SAINT ANTONS WAY
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-1065
Mailing Address - Country:US
Mailing Address - Phone:410-570-0242
Mailing Address - Fax:
Practice Address - Street 1:580 BELLERIVE RD STE 5C
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21409-4602
Practice Address - Country:US
Practice Address - Phone:410-570-0242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-14
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM05463225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist