Individual
JESSICA MICHELLE BRUBAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
16620 N 40TH ST STE G1, PHOENIX, AZ 85032-3351
(602) 363-0629
Mailing address
1814 E FRIER DR UNIT 1, PHOENIX, AZ 85020-7633
(602) 380-3568
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-17552
AZ
Other
Enumeration date
11/07/2018
Last updated
11/07/2018
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