Individual
SHAWN P EMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1430 E MISSOURI AVE STE B275, PHOENIX, AZ 85014-2490
(480) 204-1568
Mailing address
1430 E MISSOURI AVE STE B275, PHOENIX, AZ 85014-2490
(480) 204-1568
(703) 670-8213
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810003640
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
196418
ANTHEM BC BS
VA
Enumeration date
11/09/2006
Last updated
11/15/2023
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