Individual
SHAWNA BAULDRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1327 E 10TH PL, CASA GRANDE, AZ 85222-3677
(520) 876-5700
Mailing address
1327 E 10TH PL, CASA GRANDE, AZ 85222-3677
(520) 876-5700
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
10761
AZ
Other
Enumeration date
04/13/2007
Last updated
07/08/2007
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