Provider Demographics
NPI:1487537460
Name:JEFFREY, JESSICA LYNN ANDERSON
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:LYNN ANDERSON
Last Name:JEFFREY
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:JESSICA
Other - Middle Name:LYNN
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1013 GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-2820
Mailing Address - Country:US
Mailing Address - Phone:810-259-5138
Mailing Address - Fax:
Practice Address - Street 1:1013 GARFIELD ST
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-2820
Practice Address - Country:US
Practice Address - Phone:810-259-5138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician