Individual
CAROL JERNIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1138 W GLENROSA AVE, PHOENIX, AZ 85013-2810
(602) 459-0455
Mailing address
1138 W GLENROSA AVE, PHOENIX, AZ 85013-2810
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/31/2022
Last updated
01/31/2022
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