Individual
JESSICA AMY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4530 E MUIRWOOD DR, PHOENIX, AZ 85048-7639
(480) 610-6981
(480) 898-7419
Mailing address
4530 E MUIRWOOD DR, PHOENIX, AZ 85048-7639
(480) 610-6981
(480) 898-7419
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/19/2018
Last updated
07/19/2018
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