Individual
JEAN COLLINS-STUCKERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISAC
Contact information
Practice address
4545 N 36TH ST STE 121, PHOENIX, AZ 85018-3473
(602) 402-3676
(602) 381-3676
Mailing address
4545 N 36TH ST STE 121, PHOENIX, AZ 85018-3473
(602) 402-3676
(602) 381-3676
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10022
AZ
Other
Enumeration date
01/21/2011
Last updated
01/21/2011
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