Individual
JILL A DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 HEADWATERS DR, HARWICH, MA 02645-1028
(508) 430-1717
Mailing address
118 WAYLAND RD, HYANNIS, MA 02601-2455
(508) 414-0480
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9234
MA
Other
Enumeration date
08/20/2019
Last updated
08/20/2019
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