| Shine His Light Llc | |
|
30817 N 144th St Scottsdale AZ 85262-6837 | |
| (480) 414-3916 | |
| Not Available |
| Full Name | Shine His Light Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 30817 N 144th St, Scottsdale, Arizona |
| Authorized Official Name and Position | Jacqueline Kaleigh Rogers (OWNER AND EMPLOYEE) |
| Authorized Official Contact | 4804143916 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shine His Light Llc Po Box 551 Apache Junction AZ 85117-4019 Ph: () - | Shine His Light Llc 30817 N 144th St Scottsdale AZ 85262-6837 Ph: (480) 414-3916 |
| NPI Number | 1902678600 |
|---|---|
| Provider Enumeration Date | 10/25/2023 |
| Last Update Date | 11/02/2023 |
| Certification Date | 11/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902678600 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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