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1154961464
SHOCKIE M DERSNO
PHOENIX, AZ
NPI
1154961464
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: AZ LPC-18672)
Enumeration Date
2020-01-14
Last Update Date
2020-01-28
Business Address
SHOCKIE M DERSNO LPC
1840 N 95TH AVE STE 146
PHOENIX, AZ 85037-4446
Phone number: 404-953-2501
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Mailing Address
SHOCKIE M DERSNO LPC
1840 N 95TH AVE STE 146
PHOENIX, AZ 85037-4446
Phone number: 623-234-9828
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