Provider Demographics
NPI:1568851947
Name:STEFANSKI, JESSICA MICHELE (NMD, LAC)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:MICHELE
Last Name:STEFANSKI
Suffix:
Gender:F
Credentials:NMD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9316 E RAINTREE DR STE 140
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-3007
Mailing Address - Country:US
Mailing Address - Phone:480-999-4404
Mailing Address - Fax:833-234-2935
Practice Address - Street 1:9316 E RAINTREE DR STE 140
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-3007
Practice Address - Country:US
Practice Address - Phone:480-999-4404
Practice Address - Fax:833-234-2935
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-22
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1035171100000X
AZ16-1550175F00000X, 175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist