Individual
DR. JACQUELYNN NICOSIA COPELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
901 E WILLETTA ST, PHOENIX, AZ 85006-2727
(602) 839-6900
Mailing address
901 E WILLETTA ST, PHOENIX, AZ 85006-2727
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
4594
AZ
Other
Enumeration date
03/31/2015
Last updated
03/31/2015
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