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Individual

MR. JEFFREY TODD WATERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
4011 E PROVIDENCE RD, WILLIAMSBURG, VA 23188-2783
(703) 409-6510
Mailing address
4011 E PROVIDENCE RD, WILLIAMSBURG, VA 23188-2783
(703) 409-6510

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701010822
VA

Other

Enumeration date
10/04/2021
Last updated
10/04/2021
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