Individual
JAQUELINE LEBARON JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
4602 W SWEETWATER AVE, GLENDALE, AZ 85304
(602) 896-6500
Mailing address
16334 N 73RD LN, PEORIA, AZ 85382-1806
(602) 576-5779
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP10078
AZ
Other
Enumeration date
11/01/2016
Last updated
06/20/2018
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