Individual
MRS. SHAWNEE MARIE ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25112 W SADDLE MOUNTAIN RD, MORRISTOWN, AZ 85342-9068
(623) 388-9865
Mailing address
25112 W SADDLE MOUNTAIN RD, MORRISTOWN, AZ 85342-9068
(623) 388-9865
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
10949
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048441
—
AZ
Enumeration date
11/15/2006
Last updated
07/09/2007
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