Organization
SHINE HIS LIGHT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE KALEIGH ROGERS (OWNER AND EMPLOYEE)
(480) 414-3916
Entity
Organization
Contact information
Practice address
30817 N 144TH ST, SCOTTSDALE, AZ 85262-6837
(480) 414-3916
Mailing address
PO BOX 551, APACHE JUNCTION, AZ 85117-4019
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/25/2023
Last updated
11/02/2023
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