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1366895427
JACKIE POWELL
MESA, AZ
NPI
1366895427
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: AZ LISAC-15108)
Enumeration Date
2016-07-13
Last Update Date
2018-09-28
Business Address
JACKIE POWELL MAC, LISAC
6262 E BROADWAY RD SUITE 101
MESA, AZ 85206-6101
Phone number: 480-664-4053
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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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