Individual
MISS JACQUELINA OTILIA TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6802 PARAGON PL STE 410, RICHMOND, VA 23230-1655
(919) 358-3730
(844) 892-9261
Mailing address
6802 PARAGON PL STE 410, RICHMOND, VA 23230-1655
(919) 358-3730
(844) 892-9261
Taxonomy
Speciality
Code
Description
License number
State
225XM0800X
Mental Health Occupational Therapist
Primary
—
—
Other
Enumeration date
02/09/2019
Last updated
02/09/2019
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