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NPI Code Detail

MEDICARE: SHIRLEY A RASOR LICDC

MEDICARE: SHIRLEY A RASOR LICDC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor852089OH

General Provider Information

NPI Number : 1336384098
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHIRLEY A RASOR LICDC
Provider Business Mailing Address
First Line : 600 WALNUT ST
Second Line :
City : GREENVILLE
State : OH
Zip : 45331-1944
Country : US
Telephone Number : 937-548-6842
Fax Number : 937-548-8938
Provider Business Practice Location Address
First Line : 600 WALNUT ST
Second Line :
City : GREENVILLE
State : OH
Zip : 45331-1944
Country : US
Telephone Number : 937-548-6842
Fax Number : 937-548-8938
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2008
Last Update Date : 12/10/2008

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Directions to “ SHIRLEY A RASOR LICDC” Practice Location

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