Individual
SHEA GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17958 W BROWN ST, WADDELL, AZ 85355-4151
(623) 535-5741
(623) 466-0760
Mailing address
17958 W BROWN ST, WADDELL, AZ 85355-4151
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA11369
AZ
Other
Enumeration date
02/28/2019
Last updated
02/28/2019
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