Individual
SHANNON HALLSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
9025 E VINE AVE, MESA, AZ 85208-2346
(480) 380-3868
Mailing address
9025 E VINE AVE, MESA, AZ 85208-2346
(480) 380-3868
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1281717
ID
Other
Enumeration date
05/22/2026
Last updated
05/22/2026
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