Jiavanna Medlock

NPI #1134752074 in Sparks, Maryland

Provider Information

NPI Number: 1134752074
Entity Type: Individual
Name: Jiavanna Medlock
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Feb 19, 2020
Last Updated: Feb 19, 2020

Practice Location

Address: 14550 YORK RD
City: Sparks
State: Maryland
ZIP Code: 21152-9307
Phone: (240) 616-3861

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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