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General NPI Number Information
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NPI Number | 1184551764
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Entity Type | Individual
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Provider Name | SHANNA CHAMBERLAIN
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Gender | Female
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Dates
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Enumeration Date | 05/06/2026
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Last Update Date | 05/06/2026
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Provider Practice Location Address
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Address Line | 119 CENTER ST
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City | PLAIN CITY
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State | OH
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Zip | 43064-1101
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Country | US
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Telephone | 513-607-5128
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Fax |
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Provider Business Mailing Address
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Address Line | 8044 MONTGOMERY RD
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City | CINCINNATI
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State | OH
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Zip | 45236-2919
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Country | US
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Telephone | 513-607-5128
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | PRS.007683
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License Number State | OH
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