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Individual

JEAN WAITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
15362 BALLERINA LOOP, WOODBRIDGE, VA 22193-8530
(240) 305-9321
Mailing address
15362 BALLERINA LOOP, WOODBRIDGE, VA 22193-8530
(240) 305-9321

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
R242135
MD

Other

Enumeration date
07/05/2024
Last updated
07/05/2024
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