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Individual

MR. ERIC R SHINN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MC

Contact information

Practice address
1232 E. BROADWAY RD SUIT #120, TEMPE, AZ 85282
(480) 784-1514
(480) 967-3528
Mailing address
18115 E BELLERIVE DR, QUEEN CREEK, AZ 85242-8419

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-10282
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
614356
AZ
Enumeration date
12/20/2006
Last updated
07/09/2007
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