Individual
MRS. JESSICA L UTTERBACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
907 W AUGUSTA AVE, PHOENIX, AZ 85021-7130
(602) 377-8236
Mailing address
907 W AUGUSTA AVE, PHOENIX, AZ 85021-7130
(602) 377-8236
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-7989T
AZ
Other
Enumeration date
07/24/2023
Last updated
07/24/2023
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