Provider Demographics
NPI:1881827624
Name:LAYDEN, JESSICA JEAN (ATC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:JEAN
Last Name:LAYDEN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 S 5TH ST. APT 34
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76706
Mailing Address - Country:US
Mailing Address - Phone:785-224-8676
Mailing Address - Fax:
Practice Address - Street 1:1 BEAR PL UNIT 97313
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76798-7313
Practice Address - Country:US
Practice Address - Phone:254-710-4030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program