Healthcare Provider Details

I. General information

NPI: 1669514758
Provider Name (Legal Business Name): JILL TERESA CAFFREY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 11/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 W COOL DR STE 107
TUCSON AZ
85704
US

IV. Provider business mailing address

403 W COOL DR STE 107
TUCSON AZ
85704-6551
US

V. Phone/Fax

Practice location:
  • Phone: 520-329-8298
  • Fax: 520-329-8311
Mailing address:
  • Phone: 520-329-8298
  • Fax: 520-329-8311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2023
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number2023
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: