Individual
SHALONDA WHITMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
699 W MAGEE RD, #23102, TUCSON, AZ 85704-4651
(216) 965-6906
(520) 750-0056
Mailing address
699 W MAGEE RD, #23102, TUCSON, AZ 85704-4651
(216) 965-6906
(520) 750-0056
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
1613394
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1613394
DES OLCR
AZ
Enumeration date
04/24/2009
Last updated
04/24/2009
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