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Individual

MR. JAY RUSSEL MCCOY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA LPC

Contact information

Practice address
11024 N 28TH DRIVE, SUITE 200, PHOENIX, AZ 85029
(602) 789-1359
(602) 866-6903
Mailing address
11024 N 28TH DRIVE, SUITE 200, PHOENIX, AZ 85029
(602) 789-1359
(602) 866-6903

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC0241
AZ

Other

Enumeration date
12/27/2006
Last updated
07/08/2007
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