Provider Demographics
NPI:1417967159
Name:DAVIDSON, JENNIFER LEIGH (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LEIGH
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
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Mailing Address - Street 1:10804 HUFFMEISTER RD STE D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3178
Mailing Address - Country:US
Mailing Address - Phone:281-477-9500
Mailing Address - Fax:281-477-9563
Practice Address - Street 1:10804 HUFFMEISTER RD STE D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3178
Practice Address - Country:US
Practice Address - Phone:281-477-9500
Practice Address - Fax:281-477-9563
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-09-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX18354235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX18354OtherLICENSE NUMBER