Provider Demographics
NPI:1962596247
Name:PRITCHETT, JENNIFER M
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:PRITCHETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 MILL LANE RD
Mailing Address - Street 2:
Mailing Address - City:FOSTER
Mailing Address - State:VA
Mailing Address - Zip Code:23056-2051
Mailing Address - Country:US
Mailing Address - Phone:804-642-2652
Mailing Address - Fax:804-642-1504
Practice Address - Street 1:3065 GEORGE WASHINGTON MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:HAYES
Practice Address - State:VA
Practice Address - Zip Code:23072-3300
Practice Address - Country:US
Practice Address - Phone:804-642-2652
Practice Address - Fax:804-642-1504
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710001290101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health