Matt, Shirley A.

Matt, Shirley A. is an individual health care provider with primary practice located at 4212 N 16Th St , Phoenix AZ 85016-5319. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Matt, Shirley A. can be contacted via phone (602) 263-1511.

Contact Information

Primary practice address
4212 N 16Th St Phoenix AZ 85016-5319
Phone: (602) 263-1511
Fax: (602) 263-1619
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LISAC-0439 Arizona

Profile Details

NPI number 1063569473
LBN Legal business name Matt, Shirley A.
Credentials LISAC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2007
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063569473 NPPES
Arizona MEDICAID 102999
Arizona Other AZ0913910

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