Individual
CAROLYN JAEDECKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11201 N TATUM BLVD STE 300, PHOENIX, AZ 85028-6039
(602) 704-4796
Mailing address
11201 N TATUM BLVD STE 300, PHOENIX, AZ 85028-6039
(602) 704-4796
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC-17408
AZ
Other
Enumeration date
02/19/2026
Last updated
02/19/2026
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