Individual
DR. JENNA R FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD LPC
Contact information
Practice address
3959 ELECTRIC RD STE 425, ROANOKE, VA 24018-4563
(540) 206-2385
Mailing address
3959 ELECTRIC RD STE 425, ROANOKE, VA 24018-4563
(540) 524-0359
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701007605
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30604011
—
KY
Enumeration date
07/23/2012
Last updated
11/24/2021
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