Provider Demographics
NPI:1962109967
Name:MAY, JESSICA NOEL (DACM, MS, LAC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:NOEL
Last Name:MAY
Suffix:
Gender:F
Credentials:DACM, MS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 6610
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85246-6610
Mailing Address - Country:US
Mailing Address - Phone:480-926-7800
Mailing Address - Fax:480-926-2260
Practice Address - Street 1:21001 N TATUM BLVD STE 78-1640
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-5244
Practice Address - Country:US
Practice Address - Phone:480-926-7800
Practice Address - Fax:480-926-2260
Is Sole Proprietor?:No
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC012150171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist