Shockie Dersno's National Provider Identifier (NPI) Details
Shockie Dersno, LPC
NPI: 1154961464
Enumeration Date: 2020-01-14
Last updated: 2020-01-28
Sole Proprietor: NO
Status: active
Postal Address: 1840 N 95TH AVE STE 146, PHOENIX, AZ
Phone: 404-953-2501
Primary Practice Address: 1840 N 95TH AVE STE 146, PHOENIX, AZ
Practice's phone: 623-234-9828