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General NPI Number Information
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NPI Number | 1881453876
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Entity Type | Individual
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Provider Name | MRS. JANA EASLEY
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Gender | Female
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Dates
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Enumeration Date | 03/13/2024
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Last Update Date | 03/13/2024
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Provider Practice Location Address
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Address Line | 2442 W ACOMA DR
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City | PHOENIX
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State | AZ
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Zip | 85023-5903
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Country | US
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Telephone | 602-809-0859
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Fax |
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Provider Business Mailing Address
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Address Line | 2442 W ACOMA DR
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City | PHOENIX
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State | AZ
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Zip | 85023-5903
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Country | US
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Telephone | 602-809-0859
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Fax | 602-346-0399
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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-16442
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License Number State | AZ
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