Sheri Ledawn Rudin

Individual provider Active NPI Child Mental Illness Respite Care · Seligman, AZ

NPI 1417280413 · NPPES record last updated Sep 9, 2009

Key facts

NPI
1417280413
Entity type
Individual (NPI type 1)
Primary specialty
Child Mental Illness Respite Care 385HR2055X
License
1657556 (AZ)
Practice address
525 Sierra Verde Rd
Seligman, AZ 86337
Phone
(928) 699-8790
NPI assigned
Sep 9, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1657556AZMDChild Mental Illness Respite Care

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Child Mental Illness Respite Care 385HR2055X 1657556 AZ Yes

Addresses

Primary practice location

525 Sierra Verde Rd
Seligman, AZ 86337

Mailing address

PO Box 82
Seligman, AZ 86337-0082
Phone (928) 699-8790

Other providers in Seligman, AZ

All providers in Seligman, AZ · Child Mental Illness Respite Care in Arizona

Sources for this page

Verify at the official NPI Registry.