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Individual

JASON KELLY DUCAT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
500 N US HIGHWAY 89, PRESCOTT, AZ 86313-5001
(928) 445-4860
Mailing address
500 N US HIGHWAY 89, PRESCOTT, AZ 86313-5001
(928) 445-4860

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-18540
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LMSW-18540
LICENSED MASTER SOCIAL WORKER
AZ
Enumeration date
09/28/2020
Last updated
09/28/2020
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