Individual
SERENA JAECQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
818 NEWTOWN RD, VIRGINIA BEACH, VA 23462-1116
(757) 473-8016
Mailing address
818 NEWTOWN RD, VIRGINIA BEACH, VA 23462-1116
(757) 473-8016
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
0119000308
VA
225X00000X
Occupational Therapist
Primary
0119000308
VA
Other
Enumeration date
03/19/2014
Last updated
03/16/2022
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