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General NPI Number Information
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NPI Number | 1821661059
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Entity Type | Individual
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Provider Name | JASON DUMITRU MS
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Gender | Male
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Dates
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Enumeration Date | 07/24/2021
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 18001 N 79TH AVE STE B20
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City | GLENDALE
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State | AZ
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Zip | 85308-8390
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Country | US
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Telephone | 847-322-0518
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Fax |
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Provider Business Mailing Address
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Address Line | 14719 W MARY CT
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City | SURPRISE
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State | AZ
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Zip | 85374-9677
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Country | US
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Telephone | 847-322-0518
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT-16100
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License Number State | AZ
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