Individual
JAYDEN DODEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA BHT
Contact information
Practice address
23460 N 19TH AVE STE 220, PHOENIX, AZ 85027-2170
(602) 989-8899
(602) 900-0969
Mailing address
17505 N 79TH AVE STE 105, GLENDALE, AZ 85308-8724
(602) 989-8899
(602) 900-0969
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
BHT
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043982747
NPI TYPE 2 ORGANIZATIONAL/FACILITY
AZ
05
—
125011
—
AZ
01
—
1740851542
JANUARY HARTZE OF HEALING HARTZE INDIVIDUAL NPI
AZ
01
—
CSLG13230
ARIZONA DEPARTMENT OF HEALTH SERVICES
AZ
Enumeration date
02/23/2024
Last updated
03/05/2024
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