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Individual

SHALONDA CHEATHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6834 W DARREL RD, LAVEEN, AZ 85339-2671
(602) 455-4626
(602) 455-2624
Mailing address
6834 W DARREL RD, LAVEEN, AZ 85339-2671
(602) 455-4626
(602) 455-2624

Taxonomy

Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
5197315
AZ
385HR2055X
Child Mental Illness Respite Care
5197315
AZ

Other

Enumeration date
03/17/2014
Last updated
03/10/2020
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