Individual
JESSICA LEANN DAMRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
424 LEWIS HARGETT CIR STE B100, LEXINGTON, KY 40503-3683
(859) 475-4305
Mailing address
2108 SAINT MATHILDA DR, LEXINGTON, KY 40502-1128
(859) 693-9942
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
269236
KY
225XP0200X
Pediatric Occupational Therapist
269236
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269236
—
KY
Enumeration date
04/12/2021
Last updated
04/12/2021
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