Individual
MRS. JESSICA MARIE LAZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 N 18TH ST, PHOENIX, AZ 85006-4103
(602) 340-8717
Mailing address
7977 W WACKER RD UNIT 182, PEORIA, AZ 85381-4067
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/29/2017
Last updated
12/29/2017
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