Individual
JACQUELYN MARIE SIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L, CHT
Contact information
Practice address
4819 RIVERSIDE DR STE C, DANVILLE, VA 24541-5581
(434) 421-6179
Mailing address
2050 POINTER RD, ALTON, VA 24520-3508
(757) 448-5674
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0119003320
VA
225XH1200X
Hand Occupational Therapist
Primary
0119003320
VA
Other
Enumeration date
01/09/2023
Last updated
04/15/2026
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