Individual
JENNIFER LYNN SUTHERLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
350 POPLAR DR, PETERSBURG, VA 23805-9367
(804) 733-6874
Mailing address
422 HIGH ST APT 202, PETERSBURG, VA 23803-3818
(252) 883-3788
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810005846
VA
Other
Enumeration date
10/19/2017
Last updated
10/19/2017
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