Individual
JILLIAN VANSELOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
34225 N 27TH DR, BLDG 5 SUITE 138, PHOENIX, AZ 85085-6087
(602) 810-1130
Mailing address
34225 N 27TH DR, BLDG 5 SUITE 138, PHOENIX, AZ 85085-6087
(602) 810-1130
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13339
AZ
Other
Enumeration date
12/11/2013
Last updated
12/11/2013
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