Individual
MS. KAYDE JANE JACQUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5224 ANDOVER RD, VIRGINIA BEACH, VA 23464-5950
(757) 620-2511
Mailing address
5224 ANDOVER RD, VIRGINIA BEACH, VA 23464-5950
(757) 620-2511
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000939
VA
Other
Enumeration date
11/18/2011
Last updated
11/18/2011
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