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General NPI Number Information
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NPI Number | 1437842663
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Entity Type | Individual
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Provider Name | STEPHANIE LYNN SHORES LPC ASSOCIATE
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Gender | Female
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Dates
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Enumeration Date | 06/01/2023
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Last Update Date | 06/01/2023
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Provider Practice Location Address
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Address Line | 8001 BEDWELL PL
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City | AMARILLO
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State | TX
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Zip | 79121-1047
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Country | US
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Telephone | 806-359-5188
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 50626
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City | AMARILLO
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State | TX
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Zip | 79159-0626
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Country | US
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Telephone | 806-359-5188
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 87261
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License Number State | TX
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