Individual
MRS. JESSICA LAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4400 N HIGHWAY 19A, UNIT 10, MOUNT DORA, FL 32757-2032
(407) 843-1760
(407) 843-1767
Mailing address
741 W COLONIAL DR, ORLANDO, FL 32804-7343
(407) 843-1760
(407) 843-1760
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FL9220132
—
FL
Enumeration date
04/11/2017
Last updated
04/11/2017
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