Individual
DR. JESSICA O KOSTELNIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., LCP
Contact information
Practice address
205 E HIGH ST, JAO5J@VIRGINIA.EDU, CHARLOTTESVILLE, VA 22902-5516
(434) 963-0324
(434) 971-4525
Mailing address
205 EAST HIGH STREET, JAO5J@VIRGINIA.EDU, CHARLOTTESVILLE, VA 22902
(434) 963-0324
(434) 971-4525
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810004607
VA
Other
Enumeration date
08/07/2012
Last updated
08/07/2012
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