Individual
JEREMY 4805799902 WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSSR
Contact information
Practice address
8101 N BLACK CANYON HWY, PHOENIX, AZ 85021-4857
(480) 579-9902
Mailing address
8101 N BLACK CANYON HWY, PHOENIX, AZ 85021-4857
(480) 579-9902
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
AZ
Other
Enumeration date
11/17/2025
Last updated
11/17/2025
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