Individual
MECHELLE LYNETTE SHEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2805 E 9TH ST, DOUGLAS, AZ 85607-2715
(830) 391-5454
Mailing address
2805 E 9TH ST, DOUGLAS, AZ 85607-2715
(830) 391-5454
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
2397966
AZ
Other
Enumeration date
03/22/2011
Last updated
03/22/2011
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