Individual
JESSICA NICOLE SOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4210 W ORCHID LN, PHOENIX, AZ 85051-4667
(480) 799-6693
Mailing address
4210 W ORCHID LN, PHOENIX, AZ 85051-4667
(480) 799-6693
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/27/2020
Last updated
02/27/2020
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