Individual
MR. JAN HAROLD SCOUTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MDIV
Contact information
Practice address
5062 N 19TH AVE, SUITE 102, PHOENIX, AZ 85015-3225
(623) 939-6567
Mailing address
5062 N 19TH AVE, SUITE 102, PHOENIX, AZ 85015-3225
(623) 939-6567
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISCAC-1653
AZ
Other
Enumeration date
11/03/2010
Last updated
11/03/2010
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