Individual
MS. SHEILA DIANE ANDREA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RT(R)(M)
Contact information
Practice address
11405 N CRESTVIEW ST., FLAGSTAFF, AZ 86004-5215
(928) 637-8724
Mailing address
11405 N CRESTVIEW ST, FLAGSTAFF, AZ 86004-5215
(928) 637-8724
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
CRT-13822
AZ
2471M2300X
Mammography Radiologic Technologist
Primary
CMT-2739
AZ
Other
Enumeration date
08/31/2010
Last updated
08/31/2010
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