Individual
SHARNNET EZELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6827 W NANCY LN, LAVEEN, AZ 85339-2658
(620) 518-2294
Mailing address
6827 W NANCY LN, LAVEEN, AZ 85339-2658
(620) 518-2294
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
5408780
AZ
Other
Enumeration date
11/19/2013
Last updated
11/19/2013
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