Individual
JODY MARIE GASKILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
1294 FAWN BROOK DR, SHOW LOW, AZ 85901-7654
(928) 532-1532
Mailing address
1294 FAWN BROOK DR, SHOW LOW, AZ 85901-7654
(928) 532-1532
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-17517
AZ
Other
Enumeration date
10/23/2019
Last updated
10/23/2019
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