Individual
JACQUELINE RAE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT, QMHPC
Contact information
Practice address
1741 HIAWATHA DR, VIRGINIA BEACH, VA 23464-8448
(757) 266-3430
Mailing address
1741 HIAWATHA DR, VIRGINIA BEACH, VA 23464-8448
(757) 266-3430
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0733007985
VA
106S00000X
Behavior Technician
Primary
RBT21152347
VA
Other
Enumeration date
10/22/2021
Last updated
10/22/2021
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