Individual
SHADALE GILLESPIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
45565 W. RAINBOW DR., MARICOPA, AZ 85139
(414) 514-9216
Mailing address
45565 W RAINBOW DR, MARICOPA, AZ 85139-6751
(414) 514-8795
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
5962979
AZ
Other
Enumeration date
10/21/2014
Last updated
10/21/2014
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