Individual
SHANNON THREADGILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8765 W KELTON LN BLDG A2B3, PEORIA, AZ 85382-3584
(602) 703-3557
Mailing address
7110 W JULIE DR, GLENDALE, AZ 85308-5830
(602) 703-3557
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11688
AZ
Other
Enumeration date
11/19/2007
Last updated
06/08/2025
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