Individual
MRS. SHELLY THOME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, CCTP, CCTSI
Contact information
Practice address
6635 W. HAPPY VALLEY ROAD, SUITE A104, #129, GLENDALE, AZ 85310-8531
(602) 649-4040
Mailing address
6635 W. HAPPY VALLEY ROAD, SUITE A104, #129, GLENDALE, AZ 85310-8730
(602) 649-4040
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC-17691
AZ
101Y00000X
Counselor
Primary
LPC17691
AZ
Other
Enumeration date
02/21/2007
Last updated
09/13/2020
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