Doctor Name: | SHANNON MCGOVERN |
NPI Number: | 1033361191 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 3973 |
Business Practice Address: | 7461 E Tanque Verde Rd Tucson, AZ - 857153477 |
Business Phone Number: | 5203529955 |
Business Fax Number: | 5203529960 |
Mailing Address: | 7461 E Tanque Verde Rd, TUCSON |
State: | AZ |
Postal Code: | 857153477 |
Phone Number: | 5203529955 |
Fax Number: | 5203529960 |
NPI Enumeration Date: | 10/21/2008 |
NPI Last Update Date: | 10/21/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 3973 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AZ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |