Individual provider · Type 1 NPI

Jacqueline Wastal

Mental Health Counselor · Phoenix, AZ

NPI number 1669106290 Active

Practice location

5040 E Shea Blvd #164
Phoenix, AZ 85028

Call (480) 641-1165 Map

Mailing address

15740 N 83rd Ave Apt 1035
Peoria, AZ 85382-3889

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1669106290

Jacqueline Wastal's National Provider Identifier is 1669106290, issued on Jul 11, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Phoenix, AZ. The record was last updated on Jul 11, 2022.