Individual
LARA SHLEEF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
750 E THUNDERBIRD RD STE 1-3, PHOENIX, AZ 85022-5306
(602) 682-7455
(602) 218-6383
Mailing address
3101 N CENTRAL AVE STE 550, PHOENIX, AZ 85012-2635
(602) 230-7373
(602) 682-7455
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5535
AZ
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
5535
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212943
—
AZ
01
—
5535
AZ STATE LICENSE NUMBER
AZ
Enumeration date
01/28/2014
Last updated
02/13/2024
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