Individual
JALEESA WASHINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
926 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1054
(757) 788-8490
Mailing address
926 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1054
(757) 788-8490
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106S00000X
Behavior Technician
Primary
RBT-18-53231
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265E
—
MA
Enumeration date
08/23/2016
Last updated
04/19/2018
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