Healthcare Provider Details

I. General information

NPI: 1902723034
Provider Name (Legal Business Name): SHANEN DUNAGAN CEO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7931 E PECOS RD STE 211
MESA AZ
85212-6511
US

IV. Provider business mailing address

7931 E PECOS RD STE 211
MESA AZ
85212-6511
US

V. Phone/Fax

Practice location:
  • Phone: 480-442-6273
  • Fax:
Mailing address:
  • Phone: 480-442-6273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: