Provider Demographics
NPI:1184881591
Name:DAVISON, JEAN M (AUD)
Entity type:Individual
Prefix:MS
First Name:JEAN
Middle Name:M
Last Name:DAVISON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17005 OLD ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-4828
Mailing Address - Country:US
Mailing Address - Phone:302-703-4025
Mailing Address - Fax:302-703-4027
Practice Address - Street 1:17005 OLD ORCHARD RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-4828
Practice Address - Country:US
Practice Address - Phone:302-703-4025
Practice Address - Fax:302-703-4027
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE020000067231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist