Provider Demographics
NPI:1801473392
Name:LEIGH, JESSICA
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:LEIGH
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 1:3900 S STONEBRIDGE DR STE 1302
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-8089
Mailing Address - Country:US
Mailing Address - Phone:469-631-7966
Mailing Address - Fax:469-631-7988
Practice Address - Street 1:3900 S STONEBRIDGE DR STE 1302
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-8089
Practice Address - Country:US
Practice Address - Phone:469-631-7966
Practice Address - Fax:469-631-7988
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-29
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX130962225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist