Individual
TIMOTHY SHANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
58-130 KAMEHAMEHA HWY, HALEIWA, HI 96712-9714
(480) 987-2053
Mailing address
20275 E RITTENHOUSE RD STE 105, QUEEN CREEK, AZ 85142-1661
(480) 987-2053
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/23/2021
Last updated
08/23/2021
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