Provider Demographics
NPI:1629122189
Name:ZANDREWS, JACQUELYN JOY (MS MSW LISW)
Entity Type:Individual
Prefix:MS
First Name:JACQUELYN
Middle Name:JOY
Last Name:ZANDREWS
Suffix:
Gender:F
Credentials:MS MSW LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7655 E ALHAMBRA
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85650-9106
Mailing Address - Country:US
Mailing Address - Phone:520-378-6875
Mailing Address - Fax:
Practice Address - Street 1:25 EL CAMINO REAL
Practice Address - Street 2:SUITE 4
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635
Practice Address - Country:US
Practice Address - Phone:520-417-0996
Practice Address - Fax:520-417-2042
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSW228311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical