Provider Information for 1366738783
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AISHA A JAKACHIRA MS, LPC, CSAC
Sex: Female
NPI: 1366738783
Last Updated: 2017-11-15
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||||||
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| NPI | 1366738783 | ||||||||||||||||||||
| Enumeration Date | 2011-06-23 | ||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||||||
| Status | Active | ||||||||||||||||||||
| Mailing Address | PO BOX 36295 TUCSON, AZ 85740-6295 United States Phone: 414-688-4806 | Fax: | ||||||||||||||||||||
| Primary Practice Address | PO BOX 36295 TUCSON, AZ 85740-6295 United States Phone: 414-688-4806 | Fax: | ||||||||||||||||||||
| Secondary Practice Address(es) | PO BOX 36295 | ||||||||||||||||||||
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