Individual
JESSICA DAWN ENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PRSS
Contact information
Practice address
420 HOLLIDAY RUN RD, DAWSON, WV 24910-9263
(304) 392-5464
Mailing address
125 MO HOLLOW DR, MEADOW BRIDGE, WV 25976-4500
(304) 312-6748
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
WV
Other
Enumeration date
02/16/2026
Last updated
02/16/2026
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