Individual
JESSLYN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
RBT-18-63386
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-18-63386
BACB
TX
Enumeration date
08/28/2018
Last updated
08/28/2018
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