Doctor Name: | JENNIFER LYNN FIELDER |
NPI Number: | 1053576967 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. |
License Number: | 4050854 |
Business Practice Address: | 2131 S 157th Ave Goodyear, AZ - 853383357 |
Business Phone Number: | 6237724600 |
Business Fax Number: | |
Mailing Address: | 2131 S 157th Ave, GOODYEAR |
State: | AZ |
Postal Code: | 853383357 |
Phone Number: | 6237724600 |
Fax Number: | |
NPI Enumeration Date: | 07/21/2008 |
NPI Last Update Date: | 07/21/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | 4050854 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |