Provider Demographics
NPI:1952455172
Name:SCHABIN, JENNIFER FRAN (EDS)
Entity Type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:FRAN
Last Name:SCHABIN
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10015 E MOUNTAIN VIEW RD UNIT 2040
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5226
Mailing Address - Country:US
Mailing Address - Phone:480-657-9588
Mailing Address - Fax:
Practice Address - Street 1:130 W MESQUITE ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-6411
Practice Address - Country:US
Practice Address - Phone:480-926-1433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool