Provider Demographics
NPI:1265691406
Name:ZORN, SHELLYANN KAONOHIOKALANI (MS, LMFT)
Entity type:Individual
Prefix:MS
First Name:SHELLYANN
Middle Name:KAONOHIOKALANI
Last Name:ZORN
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:MS
Other - First Name:SHELLYANN
Other - Middle Name:K
Other - Last Name:GUERRERO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, LMFT
Mailing Address - Street 1:5320 E GRAY WOLF TRL
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-5211
Mailing Address - Country:US
Mailing Address - Phone:713-882-3680
Mailing Address - Fax:
Practice Address - Street 1:5320 E GRAY WOLF TRL
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-5211
Practice Address - Country:US
Practice Address - Phone:281-915-9661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX200967106H00000X
AZ16093106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist