JESSICA MARIE BUTALA

LYNCHBURG, VA
NPI1578983854
Former NameJESSICA MARIE RICHARDSON
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry
(Licence: VA  0102205632)
Additional Taxonomies2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: VA  0102205632)
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: PA  Os019421)
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry
(Licence: PA  oSo19421)
Enumeration Date2014-04-24
Last Update Date2020-01-12
Business Address
JESSICA MARIE BUTALA DO
2402 ATHERHOLT RD
LYNCHBURG, VA 24501
Phone number: 434-947-5967
Mailing Address
JESSICA MARIE BUTALA DO
2402 ATHERHOLT RD
LYNCHBURG, VA 24501-2148
Phone number: 434-947-5967