Provider Demographics
NPI:1093063315
Name:BUNCE, JESSICA RENEE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:RENEE
Last Name:BUNCE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:RENEE
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:7809 LAUREL AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45243-2673
Mailing Address - Country:US
Mailing Address - Phone:513-800-3672
Mailing Address - Fax:
Practice Address - Street 1:7809 LAUREL AVE STE 2
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45243-2673
Practice Address - Country:US
Practice Address - Phone:513-800-3672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-16
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7286103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical