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General NPI Number Information
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NPI Number | 1972485233
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Entity Type | Individual
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Provider Name | AMY SHUPE
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Gender | Female
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Dates
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Enumeration Date | 07/25/2025
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 19721 E EMPEROR BLVD
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-8661
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Country | US
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Telephone | 435-592-0089
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Fax |
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Provider Business Mailing Address
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Address Line | 7565 E EAGLE CREST DR STE 101
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City | MESA
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State | AZ
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Zip | 85207-1041
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Country | US
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Telephone | 480-641-1165
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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 |
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License Number State |
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