Individual
CHRISTY RENEE SHIVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21985 E ROSA RD, QUEEN CREEK, AZ 85142-4587
(480) 226-5832
Mailing address
21985 E ROSA RD, QUEEN CREEK, AZ 85142-4587
(480) 226-5832
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA12985
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLPA12985
SLPA LICENSE
AZ
Enumeration date
04/19/2021
Last updated
04/19/2021
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