Individual
JESSICA HOLLOMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 N MAIN ST, SUFFOLK, VA 23434-4529
(757) 925-6764
Mailing address
100 N MAIN ST, SUFFOLK, VA 23434-4529
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
0119007090
VA
Other
Enumeration date
05/29/2014
Last updated
08/25/2022
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