Provider Demographics
NPI:1023179868
Name:DOVER, SHANNI (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHANNI
Middle Name:
Last Name:DOVER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 E YALE DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1928
Mailing Address - Country:US
Mailing Address - Phone:480-768-9850
Mailing Address - Fax:
Practice Address - Street 1:1500 N SCOVEL ST
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-1698
Practice Address - Country:US
Practice Address - Phone:480-941-2220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist