Individual
JACQUELINE MARY HENRETIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1840 E BROADWAY RD, TEMPE, AZ 85282-1614
(022) 437-2776
(480) 927-1092
Mailing address
3003 N CENTRAL AVE STE 1600, PHOENIX, AZ 85012-2908
(602) 323-3492
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
PSY-005432
AZ
Other
Enumeration date
09/11/2013
Last updated
08/05/2021
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