Provider Demographics
NPI:1427460831
Name:DOBSON, JESSICA SUE (OTR/L)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:SUE
Last Name:DOBSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4435 WILLOW BEND DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77707-5419
Mailing Address - Country:US
Mailing Address - Phone:651-895-5910
Mailing Address - Fax:
Practice Address - Street 1:160 DOWLEN RD
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-5918
Practice Address - Country:US
Practice Address - Phone:409-861-1000
Practice Address - Fax:409-861-2241
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-20
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114394225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics