Most Relevant Information
Provider Data
| NPI Number: | 1003355751 |
| Provider Name: | JESSICA LYNN DAVIDSON |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/14/2017 |
| Last Updated: | 07/06/2022 |
Provider Practice Location
182 SW ACADEMY ST
DALLAS
OR
973381996
Practice Location Phone/Fax
| Phone: | 5036239289 |
| Fax: |
Provider Mailing Location
182 SW ACADEMY ST
DALLAS
OR
973381996
Provider Mailing Phone/Fax
| Phone: | 5036239289 |
| Fax: |