Most Relevant Information
Provider Data
| NPI Number: | 1003519216 |
| Provider Name: | JENNIFER SONG |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/24/2023 |
| Last Updated: | 04/02/2024 |
Provider Practice Location
26224 N TATUM BLVD STE 5
PHOENIX
AZ
850507500
Practice Location Phone/Fax
| Phone: | 4808827580 |
| Fax: | 4805637442 |
Provider Mailing Location
7400 E THOMPSON PEAK PKWY
SCOTTSDALE
AZ
852554109
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |