Individual
JASCELYN ANN REVLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
2120 S MCCLINTOCK DR, STE. 105, TEMPE, AZ 85282-2692
(480) 804-0326
(480) 302-7884
Mailing address
1400 E SOUTHERN AVE, STE. 735, TEMPE, AZ 85282-5691
(480) 804-0326
(480) 248-2164
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-15253
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024537
—
AZ
Enumeration date
05/15/2008
Last updated
07/30/2015
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