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Individual
SHANE CHAMBERLIN
Active
Individual
SHANE CHAMBERLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSL
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
BH005766
PA
101YM0800X
Mental Health Counselor
Primary
BH005766
PA
101YP1600X
Pastoral Counselor
BH005766
PA
103K00000X
Behavior Analyst
BH005766
PA
Other
Enumeration date
02/14/2022
Last updated
02/14/2022
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