Provider Demographics
NPI:1134325301
Name:RUBIN, JODI M (LMFT)
Entity Type:Individual
Prefix:MS
First Name:JODI
Middle Name:M
Last Name:RUBIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10149 N 92ND ST
Mailing Address - Street 2:#103
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4557
Mailing Address - Country:US
Mailing Address - Phone:480-310-6188
Mailing Address - Fax:
Practice Address - Street 1:6900 E PRINCESS DR
Practice Address - Street 2:#1203
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85054-4101
Practice Address - Country:US
Practice Address - Phone:480-310-6188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10267106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ10267OtherLMFT