Individual
MRS. JESSICA LACHELLE REVIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
400 SABAL PALM LN APT 102, CHESAPEAKE, VA 23320-1739
(757) 323-2784
Mailing address
400 SABAL PALM LN APT 102, CHESAPEAKE, VA 23320-1739
(757) 323-2784
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-254721
VA
Other
Enumeration date
01/23/2023
Last updated
01/23/2023
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