Individual
MS. JACQUELINE BOHANSKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4050 E GREENWAY RD, SUITE 2, PHOENIX, AZ 85032-4700
(602) 867-4064
(602) 867-1827
Mailing address
4050 E GREENWAY RD, SUITE 2, PHOENIX, AZ 85032-4700
(602) 867-4064
(602) 867-1827
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-1395
AZ
Other
Enumeration date
01/20/2007
Last updated
12/18/2019
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