Individual
MS. JESSICA JANE MOUTENOT-SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., MFT
Contact information
Practice address
421 PARK ST STE 2, CHARLOTTESVILLE, VA 22902-4749
(434) 260-0348
Mailing address
421 PARK ST STE 2, CHARLOTTESVILLE, VA 22902-4749
(434) 260-0348
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/09/2009
Last updated
02/24/2020
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