Individual
JACQUELINE JENDRISAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 E GURLEY ST, PRESCOTT, AZ 86301-3246
(000) 000-0000
Mailing address
600 E GURLEY ST STE A, PRESCOTT, AZ 86301-3246
(602) 541-2044
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC-20296
AZ
101Y00000X
Counselor
—
—
Other
Enumeration date
04/08/2024
Last updated
04/29/2026
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