Individual
MR. LEONARD SHIRLEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504-0649
(928) 729-8021
(928) 729-8530
Mailing address
PO BOX 649, FORT DEFIANCE, AZ 86504-0649
(928) 729-8021
(928) 729-8530
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M-06072
NM
Other
Enumeration date
07/10/2012
Last updated
07/10/2012
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