Individual
SHAREN DEE HALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
518 HIGOS WAY, NIPOMO, CA 93444-9126
(805) 709-3366
Mailing address
518 HIGOS WAY, NIPOMO, CA 93444-9126
(805) 709-3366
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
PT 36410
CA
Other
Enumeration date
06/04/2015
Last updated
06/04/2015
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