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Individual

JEANIE FELTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
516 S INDEPENDENCE BLVD STE 104, VIRGINIA BEACH, VA 23452-1153
(757) 317-4315
Mailing address
1000 JEFFERSON ST STE 2C, LYNCHBURG, VA 24504-1724

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701007470
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0701007470
LICENSE
VA
Enumeration date
02/20/2018
Last updated
02/20/2018
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