Individual
JENNIE DALCOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
3603 N 7TH AVE, PHOENIX, AZ 85013-1024
(602) 287-9125
Mailing address
17333 W RED BIRD RD, SURPRISE, AZ 85387-1024
(623) 693-0219
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC16280
AZ
Other
Enumeration date
11/23/2016
Last updated
11/23/2016
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