Individual
MS. JACQUELYN RENEE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAC, ICAADC
Contact information
Practice address
108 NORWOOD DR, COLONIAL HEIGHTS, VA 23834-1124
(676) 789-9480
(678) 623-9777
Mailing address
108 NORWOOD DR, COLONIAL HEIGHTS, VA 23834-1124
(676) 789-9480
(678) 623-9777
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3545
VA
Other
Enumeration date
06/07/2023
Last updated
06/07/2023
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