Individual
MS. KIMBERLY SHREEVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1801 W DEUCE OF CLUBS, SHOW LOW, AZ 85901-2705
(928) 537-7480
(928) 532-0255
Mailing address
200 N 4TH AVE, SHOW LOW, AZ 85901-4648
(928) 532-7171
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0000
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000
FOSTER CARE
AZ
Enumeration date
03/12/2007
Last updated
07/08/2007
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