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Individual

AMY LYNNE SHULL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MFT

Contact information

Practice address
1006 ROBERTSON ST STE 110, FORT COLLINS, CO 80524-3948
(650) 504-0539
Mailing address
2003 BALLYNEAL DR, FORT COLLINS, CO 80524-2862
(650) 504-0539

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
14371
CO
106H00000X
Marriage & Family Therapist
Primary
1500
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
62984853
CO
Enumeration date
04/18/2007
Last updated
08/05/2025
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