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1003328865
KEVIN JESSUP
PHOENIX, AZ
NPI
1003328865
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: AZ LAC-14006)
Enumeration Date
2017-11-01
Last Update Date
2017-11-01
Business Address
KEVIN JESSUP LAC
4214 N 19TH PL
PHOENIX, AZ 85016-5427
Phone number: 602-460-5350
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Mailing Address
KEVIN JESSUP LAC
4214 N 19TH PL
PHOENIX, AZ 85016-5427
Phone number: 602-460-5350
Copy
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