Provider Demographics
NPI:1518394097
Name:SNEED, JESSICA (PHD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:SNEED
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:HAWKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5635 N SCOTTSDALE RD STE 170
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-5945
Mailing Address - Country:US
Mailing Address - Phone:602-714-7929
Mailing Address - Fax:
Practice Address - Street 1:5635 N SCOTTSDALE RD STE 170
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85250-5945
Practice Address - Country:US
Practice Address - Phone:602-714-7929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-30
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPSY-004991103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist