Individual
JONATHON SHASTEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, NCSP, LP
Contact information
Practice address
1745 S ALMA SCHOOL RD STE 145, MESA, AZ 85210-3049
(602) 704-2345
Mailing address
1745 S ALMA SCHOOL RD STE 145, MESA, AZ 85210-3049
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
005982
AZ
Other
Enumeration date
03/21/2025
Last updated
03/21/2025
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