Individual
JEREMY ANDREW COURTNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
4712 DOUBLE A RANCH RD., ASH FORK, AZ 86320
(928) 707-2393
Mailing address
PO BOX 806, ASH FORK, AZ 86320-0806
(928) 707-2393
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-11472
AZ
Other
Enumeration date
04/04/2013
Last updated
08/16/2013
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