Provider Demographics
NPI:1548385222
Name:PALMER, SHONA KATHLENE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHONA
Middle Name:KATHLENE
Last Name:PALMER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:SHONA
Other - Middle Name:KATHLENE
Other - Last Name:STEVENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:47 FIDDLESTICKS TRL
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-9598
Mailing Address - Country:US
Mailing Address - Phone:479-721-2210
Mailing Address - Fax:
Practice Address - Street 1:CENTER FOR PSYCHOLOGY, 1601 RAINBOW ROAD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758
Practice Address - Country:US
Practice Address - Phone:479-254-1144
Practice Address - Fax:479-254-1099
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR04-15P103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5Y063Medicare ID - Type Unspecified