Individual
JESSICA NICOLE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
8 WALTER MARTIN RD NE, FORT WALTON BEACH, FL 32548-4960
(850) 862-7227
Mailing address
2505 GEORGETOWN LN, FORT WALTON BEACH, FL 32547-6818
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT14375
FL
Other
Enumeration date
11/03/2010
Last updated
11/03/2010
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