Individual
MAYRA LORENA JIRAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2423 W. DUNLAP AVE., SUITE 140, PHOENIX, AZ 85021-2830
(602) 279-5351
(602) 279-5361
Mailing address
4041 N CENTRAL AVE BLDG C, PHOENIX, AZ 85012-3313
(602) 279-5262
(602) 279-5390
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LISAC-11404
AZ
101Y00000X
Counselor
LPC-11608
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
994609
—
AZ
Enumeration date
04/04/2006
Last updated
08/26/2014
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