| Doctor Name: | DR. JESSICA LEE DIEBOLD |
| NPI Number: | 1750639076 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT, DPT |
| License Number: | 1218960 |
| Business Practice Address: | 2318 San Jacinto Blvd Suite 108 Denton, TX - 762057535 |
| Business Phone Number: | 9403809111 |
| Business Fax Number: | |
| Mailing Address: | 1104 Chapel Dr, DENTON |
| State: | TX |
| Postal Code: | 762058064 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 08/16/2012 |
| NPI Last Update Date: | 08/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 1218960 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |