Most Relevant Information
Provider Data
| NPI Number: | 1003666140 |
| Provider Name: | CARLY JACOBS MT-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 225A00000X |
| Specialty: | Music Therapist |
| License Number: | 18656 |
Most Important Dates
| Enumeration Date: | 03/22/2024 |
| Last Updated: | 03/22/2024 |
Provider Practice Location
200 E CURRY RD
TEMPE
AZ
852812009
Practice Location Phone/Fax
| Phone: | 6232589803 |
| Fax: |
Provider Mailing Location
8559 W ANDREA DR
PEORIA
AZ
853833886
Provider Mailing Phone/Fax
| Phone: | 6232589803 |
| Fax: |