Individual
JESSICA DAVIS JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
35 PEARL ST STE 100, BROCKTON, MA 02301-2866
(508) 588-8034
(508) 897-0475
Mailing address
35 PEARL ST STE 100, BROCKTON, MA 02301-2866
(508) 588-8034
(508) 897-0475
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
AT006419
PA
231H00000X
Audiologist
Primary
AUD100190
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1030512850001
—
PA
01
—
13592238
CAQH
—
Enumeration date
07/01/2015
Last updated
08/13/2025
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