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General NPI Number Information
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NPI Number | 1306501150
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Entity Type | Individual
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Provider Name | SHANIA COLLINS LPC
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Gender | Female
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Dates
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Enumeration Date | 11/06/2021
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 4657 S LAKESHORE DR STE 1
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City | TEMPE
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State | AZ
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Zip | 85282-7170
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Country | US
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Telephone | 480-718-1261
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Fax |
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Provider Business Mailing Address
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Address Line | 6913 W CARTER RD
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City | LAVEEN
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State | AZ
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Zip | 85339-7054
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Country | US
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Telephone | 708-663-8495
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 23388
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License Number State | AZ
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