| Doctor Name: | MRS. SHELLEY SUE STISSER |
| NPI Number: | 1003061946 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | LPC12877 |
| Business Practice Address: | 13460 N 94th Dr Ste K3 Peoria, AZ - 853814249 |
| Business Phone Number: | 6239743333 |
| Business Fax Number: | 6239743390 |
| Mailing Address: | 9342 S 182nd Ln, GOODYEAR |
| State: | AZ |
| Postal Code: | 853385254 |
| Phone Number: | 6238107266 |
| Fax Number: | 6233211378 |
| NPI Enumeration Date: | 11/19/2008 |
| NPI Last Update Date: | 11/19/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LPC12877 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |