Individual
SHANNON ELIZABETH PACKARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3704 E SPARROW LN, CAMP VERDE, AZ 86322-6142
(928) 327-6325
Mailing address
3170 STILLWATER DR, PRESCOTT, AZ 86305-7151
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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