Individual
MRS. JESSICA DAWN BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1414 LEXINGTON GREEN LN, SANFORD, FL 32771-1015
(407) 792-0900
(407) 369-8959
Mailing address
1414 LEXINGTON GREEN LN, SANFORD, FL 32771-1015
(407) 792-0900
(407) 369-8959
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
IMT13733
FL
Other
Enumeration date
02/08/2010
Last updated
06/06/2012
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