Individual
JEREMY SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
149 W HELENA DR, PHOENIX, AZ 85023-6558
(425) 736-2327
Mailing address
149 W HELENA DR, PHOENIX, AZ 85023-6558
(425) 736-2327
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-22770
AZ
Other
Enumeration date
09/18/2025
Last updated
09/18/2025
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