MEDICARE: MS. AMY SHINER MC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC 12234	AZ

General Provider Information

NPI Number	:	1447479019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AMY SHINER MC

Provider Business Mailing Address
First Line	:	1931 E CAMPBELL TER
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85718-5951
Country	:	US
Telephone Number	:	520-297-8820
Fax Number	:

Provider Business Practice Location Address
First Line	:	5956 E PIMA ST
Second Line	:	SUITE 130
City	:	TUCSON
State	:	AZ
Zip	:	85712-4375
Country	:	US
Telephone Number	:	520-297-8820
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	07/08/2007

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