Provider Demographics
NPI:1932354529
Name:MEADE, JENNIFER M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:M
Last Name:MEADE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20500 REMUDA LN
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22514-2867
Mailing Address - Country:US
Mailing Address - Phone:804-632-5637
Mailing Address - Fax:
Practice Address - Street 1:20500 REMUDA LN
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:VA
Practice Address - Zip Code:22514-2867
Practice Address - Country:US
Practice Address - Phone:804-632-5637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003958103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical