NPI 1033579222

Kamiah Patrice Jackson

Practitioner Developmental Therapist Virginia Beach, VA

Practice location

Address: 4445 Corporation Ln STE 264, Virginia Beach, VA 23462-3262
Phone: (757) 204-2691
Mailing address: 500 Fairway Dr Suite 102, Deerfield Beach, FL 33441-1814

Registered specialties

Developmental Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 222Q00000X

Other Developmental Therapist providers in Virginia →

Registry record

NPI: 1033579222
Entity type: Individual
Sex (as registered): Female
NPI issued: 1 Mar 2016
Record last updated: 1 Mar 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.