Individual
SHARON LEE LIETAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5810 S US HIGHWAY 191, SAFFORD, AZ 85546-9559
(928) 348-8891
Mailing address
5810 S US HIGHWAY 191, SAFFORD, AZ 85546-9559
(928) 348-8891
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
511497
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
511497
LICENSE
AZ
Enumeration date
01/05/2008
Last updated
01/05/2008
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