Individual
JESSICA A CIVIELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7227 E BASELINE RD STE 126, MESA, AZ 85209-5006
(480) 868-9650
(480) 834-3606
Mailing address
7227 E BASELINE RD STE 126, MESA, AZ 85209-5006
(480) 868-9650
(480) 834-3606
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LCSW-17233
AZ
1041C0700X
Clinical Social Worker
Primary
LCSW-17233
AZ
Other
Enumeration date
09/13/2018
Last updated
02/15/2023
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