Provider Demographics
NPI:1295408961
Name:SANDA, JAMILA A (LGPC)
Entity Type:Individual
Prefix:
First Name:JAMILA
Middle Name:A
Last Name:SANDA
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 RAYLON DR APT F
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4944
Mailing Address - Country:US
Mailing Address - Phone:443-857-0642
Mailing Address - Fax:
Practice Address - Street 1:300 E LOMBARD ST STE 840
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-3231
Practice Address - Country:US
Practice Address - Phone:800-994-5403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP11717101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health