Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JESSICA BOBERG HARRIS, CCC-SLP
Active Sole ProprietorAthletic Trainer · ST AUGUSTINE, FL
Registration Details
- NPI Number
- 1245486182
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 12, 2008 (17.693426579357 yrs)
- Last Updated
- Jul 21, 2022
- License
-
SA7351 (FL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
910 S WINTERHAWK DR UNIT 101ST AUGUSTINE, FL, 320863870Browse FL providers · Browse ZIP 32086
- Phone
- 9042177648
- Fax
- 3526663232
- Primary Specialty
-
Athletic Trainer
225500000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.