Individual
XAVIER LEWIS JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COUNSELOR
Contact information
Practice address
5062 N 19TH AVE STE 102, PHOENIX, AZ 85015-3225
(480) 629-5994
Mailing address
9326 W RASCON LOOP, PHOENIX, AZ 85037-6309
(602) 488-8880
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13332
AZ
Other
Enumeration date
09/02/2020
Last updated
09/02/2020
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