Individual
KATHLEEN SHEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1839
(212) 203-6795
Mailing address
9209 N 51ST DR, GLENDALE, AZ 85302-3401
(212) 203-6795
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
089770
NY
Other
Enumeration date
04/09/2015
Last updated
04/09/2015
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