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General NPI Number Information
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NPI Number | 1831894583
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Entity Type | Individual
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Provider Name | SHANE LAMBERT CDCA
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Gender | Male
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Dates
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Enumeration Date | 04/03/2023
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Last Update Date | 05/09/2023
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Provider Practice Location Address
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Address Line | 201 N 4TH ST
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City | MIAMISBURG
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State | OH
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Zip | 45342-2320
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Country | US
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Telephone | 937-238-7385
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 212
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City | XENIA
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State | OH
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Zip | 45385-0212
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Country | US
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Telephone |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CDCA.183740
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License Number State | OH
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