Provider Demographics
NPI:1942490701
Name:DAVIS, JESSICA D (EDD, LPC, NCC)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:D
Last Name:DAVIS
Suffix:
Gender:F
Credentials:EDD, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 88368
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77288-0368
Mailing Address - Country:US
Mailing Address - Phone:832-423-1757
Mailing Address - Fax:
Practice Address - Street 1:3802 TEAL MAPLE CT
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-8855
Practice Address - Country:US
Practice Address - Phone:832-423-1757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60907101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional