Individual
JESSICA HAASE KETOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
125 RIVERBEND DR STE 2, CHARLOTTESVILLE, VA 22911-8695
(434) 249-9028
(434) 961-2556
Mailing address
125 RIVERBEND DR STE 2, CHARLOTTESVILLE, VA 22911-8695
(434) 249-9028
(434) 961-2556
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701005483
VA
Other
Enumeration date
06/13/2013
Last updated
06/13/2013
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