Provider Demographics
NPI:1801205141
Name:KUBIT, JESSICA EARLY (DPT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:EARLY
Last Name:KUBIT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LYNN
Other - Last Name:EARLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1911 LINCOLN DR
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-4118
Mailing Address - Country:US
Mailing Address - Phone:410-573-1064
Mailing Address - Fax:410-573-1065
Practice Address - Street 1:1911 LINCOLN DR
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-4118
Practice Address - Country:US
Practice Address - Phone:410-573-1064
Practice Address - Fax:410-573-1065
Is Sole Proprietor?:No
Enumeration Date:2014-08-12
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2511225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist