Organization
RENEWED JOURNEY PSYCHOLOGICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE Y FORD PHD (PRESIDENT/CEO)
(520) 904-5277
Entity
Organization
Contact information
Practice address
5442 E 5TH ST STE A, TUCSON, AZ 85711-2334
(520) 904-5277
(520) 904-5277
Mailing address
PO BOX 19066, TUCSON, AZ 85731-9066
(520) 904-5277
(855) 718-2713
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195157
—
AZ
Enumeration date
08/26/2021
Last updated
01/10/2025
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