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Individual

SHAVONNE LOUIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
303 E. SOUTH MOUTAIN AVE, LOT 76, PHOENIX, AZ 85042
(480) 514-0288
Mailing address
303 E. SOUTH MOUTAIN AVE, LOT 76, PHOENIX, AZ 85042
(480) 514-0288

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency
261QA0600X
Adult Day Care Clinic/Center
Primary
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)

Other

Enumeration date
08/10/2022
Last updated
03/29/2023
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