Individual
JESSICA WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16009 ROLAND PARK PL, GAINESVILLE, VA 20155-1962
(540) 872-1679
Mailing address
16009 ROLAND PARK PL, GAINESVILLE, VA 20155-1962
(540) 872-1679
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
VA
Other
Enumeration date
10/19/2023
Last updated
10/19/2023
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