Individual
JESSICA COMBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.A.
Contact information
Practice address
379 6TH AVE W, BRADENTON, FL 34205-8820
(941) 782-4150
(941) 782-4104
Mailing address
PO BOX 9478, BRADENTON, FL 34206-9478
(941) 782-4299
(941) 782-4301
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
758588800
—
FL
Enumeration date
07/10/2006
Last updated
07/21/2022
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