1053510123

Everything you always wanted to know about DAVIS JENNIFER but were afraid to ask.

DAVIS JENNIFER

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Provider Last Name Provider First Name
DAVIS JENNIFER
Gender:
Female
Enumeration date:
2007-07-17
Last update date:
2007-07-17
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
No
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Identifiers

identifier description issuer state

Taxonomies

Taxonomy State License Number Primary?
235Z00000X Speech-Language Pathologist IA 01382 Y

Phone Numbers

Type Number
Practice Location Address Telephone Number 6158966400
Mailing Address Telephone Number 6412600379

Addresses

Type Address City State Postal Country
Mailing Address 1806 WEST ST GRINNELL IA 50112 IA
Practice Location Address 79 SIXTH AVE GRINNELL IA 0 IA

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