Jackson, Melissa Reyes

Jackson, Melissa Reyes is an sole proprietor health care provider with primary practice located at 3839 W Camelback Rd , Phoenix AZ 85019-2512. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Jackson, Melissa Reyes can be contacted via phone (602) 764-6052.

Contact Information

Primary practice address
3839 W Camelback Rd Phoenix AZ 85019-2512
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 101YS0200X Arizona

Profile Details

NPI number 1295946093
LBN Legal business name Jackson, Melissa Reyes
Credentials Master of Education (MED)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 24th, 2007
Last updated Jul 26th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295946093 NPPES
Arizona MEDICAID 897796

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