Individual
JACQUELINE IBARRA GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15825 S 46TH ST STE 126, PHOENIX, AZ 85048-0445
(480) 248-5338
Mailing address
914 E BROADWAY RD # 1055, TEMPE, AZ 85282-1502
(480) 269-7510
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-23659
AZ
Other
Enumeration date
09/15/2025
Last updated
09/15/2025
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