Provider Demographics
NPI:1215162128
Name:WAMSLEY, JODINE (MS, LAC,DIPLCH)
Entity type:Individual
Prefix:
First Name:JODINE
Middle Name:
Last Name:WAMSLEY
Suffix:
Gender:F
Credentials:MS, LAC,DIPLCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23150 N PIMA RD
Mailing Address - Street 2:SUITE 2-B
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-4334
Mailing Address - Country:US
Mailing Address - Phone:480-718-5840
Mailing Address - Fax:
Practice Address - Street 1:23150 N PIMA RD
Practice Address - Street 2:SUITE 2-B
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4334
Practice Address - Country:US
Practice Address - Phone:480-718-5840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0367171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist