Individual
JOSTIENA WANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1215 MALL DR, NORTH CHESTERFIELD, VA 23235-4737
(804) 594-3690
Mailing address
9513 CRAIGS MILL DR, GLEN ALLEN, VA 23060-3555
(708) 769-4721
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0810008919
VA
Other
Enumeration date
05/10/2025
Last updated
05/10/2025
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