Individual
JESSICA COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
137 LAXTON RD STE 200, LYNCHBURG, VA 24502-5294
(434) 515-2041
Mailing address
2116 EDINBORO AVE, LYNCHBURG, VA 24502-5321
(972) 638-9627
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
81098
TX
103K00000X
Behavior Analyst
0133002370
VA
Other
Enumeration date
05/23/2017
Last updated
10/28/2024
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