| Shawna Hale Llc | |
|
3707 E Southern Ave Mesa AZ 85206-2569 | |
| (480) 645-3177 | |
| Not Available |
| Full Name | Shawna Hale Llc |
|---|---|
| Speciality | Counselor |
| Location | 3707 E Southern Ave, Mesa, Arizona |
| Authorized Official Name and Position | Shawna Hale (OWNER) |
| Authorized Official Contact | 4806453177 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shawna Hale Llc 3707 E Southern Ave Mesa AZ 85206-2569 Ph: (480) 645-3177 | Shawna Hale Llc 3707 E Southern Ave Mesa AZ 85206-2569 Ph: (480) 645-3177 |
| NPI Number | 1306694914 |
|---|---|
| Provider Enumeration Date | 05/08/2024 |
| Last Update Date | 05/08/2024 |
| Certification Date | 05/08/2024 |
| Medicare PECOS PAC ID | 1052854403 |
|---|---|
| Medicare Enrollment ID | O20240613004037 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306694914 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Shawna Hale |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497496871 PECOS PAC ID: 1355883547 Enrollment ID: I20240603003304 |
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