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Individual

SHELBY KOSHY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4440 W HAVANA AVE, FAYETTEVILLE, AR 72704-4049
(715) 292-4329
Mailing address
4440 W HAVANA AVE, FAYETTEVILLE, AR 72704-4049
(715) 292-4329

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8253-C
AR

Other

Enumeration date
04/24/2023
Last updated
04/24/2023
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