Individual
MRS. DEBRA K. JOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
638 INDEPENDENCE PKWY STE 240, CHESAPEAKE, VA 23320-5222
(757) 277-4213
Mailing address
1833 MONUMENT DR, VIRGINIA BEACH, VA 23464-8772
(815) 272-0175
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701004469
VA
101YP2500X
Professional Counselor
180-005432
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9932273
BLUE CROSS BLUE SHEILD
IL
Enumeration date
08/29/2006
Last updated
02/19/2019
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