Individual
JASMINE CANDELARIA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3864 N 27TH AVE, PHOENIX, AZ 85017-4703
(602) 685-6000
(602) 212-7250
Mailing address
3003 N CENTRAL AVE STE 400, PHOENIX, AZ 85012-2929
(602) 685-6000
(602) 302-7925
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-20591
AZ
Other
Enumeration date
08/05/2022
Last updated
08/05/2022
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