Individual
JAELA HINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2215 LANGHORNE RD, LYNCHBURG, VA 24501-1121
(434) 948-4831
Mailing address
3410 OLD FOREST RD, LYNCHBURG, VA 24501-2915
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701007649
VA
Other
Enumeration date
05/17/2018
Last updated
05/17/2018
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