Individual
SHARLA DENEEN RENEE WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1467 E 12TH ST, CASA GRANDE, AZ 85122-3696
(520) 721-1887
(520) 407-5398
Mailing address
1467 E 12TH ST, CASA GRANDE, AZ 85122-3696
(520) 721-1887
(520) 407-5398
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171W00000X
Contractor
Primary
10706695
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10706695
ADES/DEPARTMENT OF CHILD SAFETY
AZ
Enumeration date
05/17/2010
Last updated
02/03/2023
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