Individual
DR. JACQUELINE TIANN WEBSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
924 N COUNTRY CLUB DR, MESA, AZ 85201-4108
(480) 825-4758
Mailing address
4747 N 71ST AVE, PHOENIX, AZ 85033-1406
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC-16405
AZ
Other
Enumeration date
06/14/2021
Last updated
06/14/2021
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