Individual
SHIRLEEAH FAYSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AT
Contact information
Practice address
4710 N 5TH ST, PHOENIX, AZ 85012-1738
(602) 277-3772
Mailing address
7311 E SOUTHERN AVE, APT. 3052, MESA, AZ 85209-2701
(302) 650-9410
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1197
AZ
Other
Enumeration date
08/08/2014
Last updated
08/08/2014
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