Individual
JACQUELINE RENEE' ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LISAC, CSAT
Contact information
Practice address
14300 N NORTHSIGHT BLVD STE 109, SCOTTSDALE, AZ 85260-3673
(217) 778-6442
Mailing address
14300 N NORTHSIGHT BLVD STE 109, SCOTTSDALE, AZ 85260-3673
(217) 778-6442
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-15051
AZ
Other
Enumeration date
08/26/2020
Last updated
08/26/2020
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