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NPI Code Detail

MEDICARE: JASON KLARER LAC

MEDICARE:   JASON  KLARER  LAC
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
1101Y00000XCounselorLAC-17384AZ

General Provider Information

NPI Number : 1285114413
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON KLARER LAC
Provider Business Mailing Address
First Line : 6534 W PIUTE AVE
Second Line :
City : GLENDALE
State : AZ
Zip : 85308-7060
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2320 W PEORIA AVE STE A101
Second Line :
City : PHOENIX
State : AZ
Zip : 85029-4721
Country : US
Telephone Number : 602-600-1871
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2018
Last Update Date : 12/29/2020

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Directions to “ JASON KLARER LAC” Practice Location

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