Individual
RICHARD JEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISAC
Contact information
Practice address
2532 W PEORIA AVE, PHOENIX, AZ 85029-4709
(602) 583-9742
Mailing address
2532 W PEORIA AVE, PHOENIX, AZ 85029-4709
(602) 583-9742
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-155320
AZ
Other
Enumeration date
02/14/2024
Last updated
02/14/2024
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