Individual
MRS. JOLENE K SELF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
749 BRYANTS TOWN RD, FARNHAM, VA 22460-3025
(804) 761-4579
Mailing address
749 BRYANTS TOWN RD, FARNHAM, VA 22460-3025
(804) 761-4579
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/10/2010
Last updated
12/10/2010
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