Individual
MR. DOUGLAS SEYMOUR JARDINE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LMFT
Contact information
Practice address
2649 E BEEKMAN PL, PHOENIX, AZ 85016-7485
(602) 538-9094
Mailing address
2649 E BEEKMAN PL, PHOENIX, AZ 85016-7485
(602) 538-9094
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
10136
AZ
106H00000X
Marriage & Family Therapist
11406
AZ
106H00000X
Marriage & Family Therapist
Primary
LMFT10136
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
817132
AHCCCS
AZ
Enumeration date
12/14/2006
Last updated
07/21/2022
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