Individual
JACQUELINE ANN ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
413 W CHICKASAW RD, VIRGINIA BEACH, VA 23462-6246
(757) 995-4586
Mailing address
413 W CHICKASAW RD, VIRGINIA BEACH, VA 23462-6246
(757) 995-4586
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2021
Last updated
04/06/2021
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