Individual
JESSICA ANNE WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2325 E CAMELBACK RD STE 400, PHOENIX, AZ 85016-3514
(602) 782-5222
(480) 900-8714
Mailing address
2325 E CAMELBACK RD STE 400, PHOENIX, AZ 85016-3514
(602) 782-5222
(480) 900-8714
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
AZ
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
AZ
343900000X
Non-emergency Medical Transport (VAN)
—
AZ
385H00000X
Respite Care
Primary
—
AZ
Other
Enumeration date
11/10/2025
Last updated
01/26/2026
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