Provider Demographics
NPI:1184455644
Name:BUSBY MCDONALD, JESSICA LYNN
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:LYNN
Last Name:BUSBY MCDONALD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 N MOUNT JULIET RD STE 202
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-1509
Mailing Address - Country:US
Mailing Address - Phone:731-697-2746
Mailing Address - Fax:
Practice Address - Street 1:1400 N MOUNT JULIET RD STE 202
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-1509
Practice Address - Country:US
Practice Address - Phone:731-697-2746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist