Individual
JESSICA FELTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6801 LUCY CORR CT, CHESTERFIELD, VA 23832-6657
(804) 768-7318
Mailing address
6801 LUCY CORR CT, CHESTERFIELD, VA 23832-6657
(804) 768-7318
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497884969
—
VA
Enumeration date
07/13/2018
Last updated
07/13/2018
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