Individual
JESSICA ICHA SAMBRANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAC
Contact information
Practice address
7121 W BELL RD STE 240, GLENDALE, AZ 85308-8559
(602) 529-1463
Mailing address
12618 W INDIANOLA AVE, AVONDALE, AZ 85392-6326
(480) 748-9652
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-08232T
AZ
Other
Enumeration date
11/12/2024
Last updated
11/12/2024
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