Provider Demographics
NPI:1437323490
Name:SHEWMAKER, SHONA LAREE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHONA
Middle Name:LAREE
Last Name:SHEWMAKER
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:PO BOX 74695
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85087-1012
Mailing Address - Country:US
Mailing Address - Phone:479-871-0680
Mailing Address - Fax:888-849-5696
Practice Address - Street 1:34975 N NORTH VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85086-4028
Practice Address - Country:US
Practice Address - Phone:479-871-0680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-21
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3944103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical