Individual
JACKLIN DIBIASO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCMH, NCC
Contact information
Practice address
910 S CHAPEL ST STE 102, NEWARK, DE 19713-3468
(877) 216-8505
(302) 224-1402
Mailing address
4800 N SCOTTSDALE RD STE 2500, SCOTTSDALE, AZ 85251-7630
(302) 224-1400
(302) 224-1402
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
PC-0000992
DE
101YP2500X
Professional Counselor
Primary
PC-0000992
DE
Other
Enumeration date
04/12/2021
Last updated
02/13/2024
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