MEDICARE: DR. JENNIFER DO PH. D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TS0200X	School Psychologist	4793	AZ

General Provider Information

NPI Number	:	1235671090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER DO PH. D.

Provider Business Mailing Address
First Line	:	1625 E FRYE RD
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85225-5114
Country	:	US
Telephone Number	:	480-883-4082
Fax Number	:

Provider Business Practice Location Address
First Line	:	1625 E FRYE RD
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85225-5114
Country	:	US
Telephone Number	:	480-883-4082
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2016
Last Update Date	:	01/08/2021

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