Individual
JILL D FISHBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
3603 N 7TH AVE, PHOENIX, AZ 85013-3638
(602) 206-1911
(602) 396-2525
Mailing address
3603 N 7TH AVE, PHOENIX, AZ 85013-3638
(602) 206-1911
(602) 396-2525
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC - 13630
AZ
Other
Enumeration date
07/08/2013
Last updated
07/08/2013
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