Individual
JENNY BLYTHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4121 S BRICE, MESA, AZ 85212-4183
(480) 694-3542
Mailing address
4121 S BRICE, MESA, AZ 85212-4183
(480) 694-3542
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
6083377
AZ
253J00000X
Foster Care Agency
Primary
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
Other
Enumeration date
09/20/2016
Last updated
08/26/2025
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