Individual
SHELLY NIELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1084 W. SAN TAN HILLS, QUEEN CREEK, AZ 85242
(480) 888-7515
(480) 655-6137
Mailing address
3291 E HAMPTON LN, GILBERT, AZ 85297-6522
(480) 659-9799
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP1787
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
872293
AHCCCS
AZ
Enumeration date
01/23/2007
Last updated
07/08/2007
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