Individual
KENDRA JACKIMCZYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7364 E NOPAL AVE, MESA, AZ 85209-7220
(480) 495-7979
Mailing address
7364 E NOPAL AVE, MESA, AZ 85209-7220
(480) 495-7979
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-10166
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
687296
—
AZ
Enumeration date
01/08/2007
Last updated
02/15/2019
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