Individual
MS. DIANE A. JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4212 N. 16TH STREET, PHOENIX, AZ 85016
(602) 263-1511
(602) 263-1637
Mailing address
PHOENIX INDIAN MEDICAL CENTER, P O BOX 95460, CLEVELAND, OH 44193
(602) 581-6088
(602) 263-1619
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-11484
AZ
Other
Enumeration date
10/02/2006
Last updated
06/28/2021
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