# MYALO MENTAL HEALTH, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093544603
- **Authorized official:** SHANNON BROWN PMHNP-BC (PMHNP, OWNER)
- **Authorized official phone:** (602) 647-8249

## Contact information

- **Practice address:** 21639 N 12TH AVE STE 104, PHOENIX, AZ 85027-2802
- **Practice address phone:** (602) 647-8249
- **Mailing address:** 21639 N 12TH AVE STE 104, PHOENIX, AZ 85027-2802
- **Mailing address phone:** (602) 647-8249

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/31/2024
- **Last updated:** 09/23/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 822748 | — | AZ |
| 01 | — | AP4920 | CERTIFIED NURSE PRACTITIONER LICENSE | AZ |