Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 3201026 | AZ |
NPI | 1154578649 |
---|---|
Provider Name | Jennifer Alia Corbett |
First Address | Tempe, AZ 85283-2414 |
Second Address | Tempe, AZ 85283-2414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2008 |
Last Update Date | 26/08/2008 |