Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 018387 | NY |
Y | 225X00000X | Occupational Therapist | P90132 | NY |
N | 225XE0001X | Environmental Modification | P90132 | NY |
N | 225XF0002X | Feeding, Eating & Swallowing | P90132 | NY |
N | 2251H1300X | Human Factors | P90132 | NY |
N | 225XH1300X | Human Factors | P90132 | NY |
N | 225XP0200X | Occupational Therapist - Pediatrics | P90132 | NY |
NPI | 1922431170 |
---|---|
Provider Name | Jessica M Davis |
First Address | Ovid, NY 14521-9586 |
Second Address | Rochester, NY 14623 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2013 |
Last Update Date | 10/07/2018 |