Individual
MS. ALICIA RENEE JENNINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSA
Contact information
Practice address
4624 E SANDS DR, PHOENIX, AZ 85050-6862
(518) 836-1672
Mailing address
4624 E SANDS DR, PHOENIX, AZ 85050-6862
(518) 836-1672
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
10/18/2019
Last updated
10/18/2019
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