Doctor Name: | SHAWNA BAULDRY |
NPI Number: | 1013131457 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 10761 |
Business Practice Address: | 1327 E 10th Pl Casa Grande, AZ - 852223677 |
Business Phone Number: | 5208765700 |
Business Fax Number: | |
Mailing Address: | 1327 E 10th Pl, CASA GRANDE |
State: | AZ |
Postal Code: | 852223677 |
Phone Number: | 5208765700 |
Fax Number: | |
NPI Enumeration Date: | 04/13/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385HR2055X |
License Number: | 10761 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | Respite Care, Mental Illness, Child |
Taxonomy Definition: | A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental illness, as respite for the regular caregivers. |