| Doctor Name: | JESSICA REGINA DAVIS |
| NPI Number: | 1609205616 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS CCC/SLP |
| License Number: | SL008258 |
| Business Practice Address: | 2600 W Run Rd Munhall, PA - 151202869 |
| Business Phone Number: | 4124628002 |
| Business Fax Number: | 4124622113 |
| Mailing Address: | 1229 Stratford Dr, ELIZABETH |
| State: | PA |
| Postal Code: | 150373110 |
| Phone Number: | 4122771059 |
| Fax Number: | |
| NPI Enumeration Date: | 11/11/2013 |
| NPI Last Update Date: | 11/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SL008258 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |