Individual
SHANTAYA BRIANA HULLABY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4620 W BURGESS LN, LAVEEN, AZ 85339-1922
(602) 472-9815
Mailing address
4620 W BURGESS LN, LAVEEN, AZ 85339-1922
(602) 472-9815
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
AZ
Other
Enumeration date
09/24/2025
Last updated
09/24/2025
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