Individual
JACQUELYN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
267 GRANT ST, BRIDGEPORT, CT 06610-2805
(203) 384-4553
Mailing address
267 GRANT ST, BRIDGEPORT, CT 06610-2805
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1723
CT
Other
Enumeration date
09/26/2019
Last updated
09/29/2025
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