SHANNEY SHONTTILE PORTER

PHOENIX, AZ
NPI1326232885
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy385HR2055X Respite Care, Respite Care, Mental Illness, Child
(Licence: AZ  209618)
Enumeration Date2007-08-28
Last Update Date2007-08-28
Business Address
-- SHANNEY SHONTTILE PORTER
4011 W SURREY AVE
PHOENIX, AZ 85029-1949
Phone number: 602-298-6987
Mailing Address
-- SHANNEY SHONTTILE PORTER
4011 W SURREY AVE
PHOENIX, AZ 85029-1949
Phone number: 602-298-6987