MEDICARE: JILL HESKETT

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1912231697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL HESKETT

Provider Business Mailing Address
First Line	:	3601 S 6TH AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85723-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7395 S HOUGHTON RD STE 129
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85747-3305
Country	:	US
Telephone Number	:	520-792-1450
Fax Number	:

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

Provider Enumeration Date	:	09/28/2009
Last Update Date	:	09/28/2009

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Directions to “ JILL HESKETT ” Practice Location

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