Organization
VIRGINIA THERAPEUTIC NETWORK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA ANNE JOLLEY BCBA, LBA (PART OWNER, SUPERVISING CLINICIAN)
(303) 335-8088
Entity
Organization
Contact information
Practice address
15713 MOSS FIRE CT, MOSELEY, VA 23120-1614
(303) 335-8088
Mailing address
15713 MOSS FIRE CT, MOSELEY, VA 23120-1614
(303) 335-8088
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
Other
Enumeration date
01/11/2024
Last updated
01/11/2024
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