Individual
HEATHER JOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., NCSP
Contact information
Practice address
3401 N 67TH AVE, PHOENIX, AZ 85033-4517
(623) 691-4085
Mailing address
15867 N 74TH AVE, PEORIA, AZ 85382-1812
(623) 910-1133
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
12/03/2009
Last updated
12/03/2009
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