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General NPI Number Information
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NPI Number | 1750206298
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Entity Type | Individual
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Provider Name | JENNIFER DOMEY LMSW
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Gender | Female
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Dates
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Enumeration Date | 08/12/2026
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Last Update Date | 08/12/2026
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Provider Practice Location Address
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Address Line | 2150 S COUNTRY CLUB DR STE 34
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City | MESA
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State | AZ
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Zip | 85210-6885
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Country | US
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Telephone | 480-662-6708
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Fax | 602-357-4550
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Provider Business Mailing Address
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Address Line | 14614 S 44TH ST
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City | PHOENIX
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State | AZ
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Zip | 85044-6005
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LMSW-23167
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License Number State | AZ
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