Most Relevant Information
Provider Data
| NPI Number: | 1003269143 |
| Provider Name: | JENNIFER OETJEN LAC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | LAC-15461 |
Most Important Dates
| Enumeration Date: | 07/13/2016 |
| Last Updated: | 07/13/2016 |
Provider Practice Location
1075 S AGNES LN
GILBERT
AZ
852961459
Practice Location Phone/Fax
| Phone: | 4802755700 |
| Fax: |
Provider Mailing Location
1075 S AGNES LN
GILBERT
AZ
852961459
Provider Mailing Phone/Fax
| Phone: | 4802755700 |
| Fax: |