Individual
MALLORY BROOKE JESTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3181 SHORE DR STE 201, VIRGINIA BEACH, VA 23451-1129
(757) 496-1653
Mailing address
221 ALABASTER ST, VIRGINIA BEACH, VA 23462-4432
(757) 641-8338
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131001364
VA
Other
Enumeration date
07/08/2022
Last updated
07/08/2022
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