JACKIE POWELL

MESA, AZ
NPI1366895427
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: AZ  LISAC-15108)
Enumeration Date2016-07-13
Last Update Date2018-09-28
Business Address
JACKIE POWELL MAC, LISAC
6262 E BROADWAY RD SUITE 101
MESA, AZ 85206-6101
Phone number: 480-664-4053
Mailing Address
JACKIE POWELL MAC, LISAC
6262 E BROADWAY RD SUITE 101
MESA, AZ 85206-6101
Phone number: 480-664-4053
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