Individual
JESSICA MISTY BOWAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA, CHW, DOULA
Contact information
Practice address
5589 GREENWICH RD, VIRGINIA BEACH, VA 23462-6565
(757) 401-4435
Mailing address
1209 CLAYTOR CT, CHESAPEAKE, VA 23320-8183
(915) 276-0881
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
174N00000X
Lactation Consultant (Non-RN)
—
—
224Z00000X
Occupational Therapy Assistant
212675
TX
374J00000X
Doula
Primary
—
—
Other
Enumeration date
04/07/2017
Last updated
03/28/2022
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