Individual
PRIYANKA R JAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
125 BUENA VISTA CIR, SOUTH HILL, VA 23970-1431
(434) 447-3054
Mailing address
920 OCCANECCHI TRL, EBONY, VA 23845-2046
(419) 575-2747
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202006503
VA
Other
Enumeration date
10/31/2011
Last updated
10/31/2011
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