Provider Demographics
NPI:1356507065
Name:THARPE, SHELLY D
Entity Type:Individual
Prefix:MRS
First Name:SHELLY
Middle Name:D
Last Name:THARPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 N WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-5148
Mailing Address - Country:US
Mailing Address - Phone:520-232-7400
Mailing Address - Fax:
Practice Address - Street 1:700 N WILSON AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-5148
Practice Address - Country:US
Practice Address - Phone:520-232-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool