Individual
JACLYN MARIE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
267 GRANT ST, BRIDGEPORT, CT 06610-2805
(203) 384-3000
Mailing address
200 EVERGREEN AVE APT 8B, HAMDEN, CT 06518-2725
(203) 506-2321
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
48.004771
CT
Other
Enumeration date
11/06/2017
Last updated
11/06/2017
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