Individual
ADAM SHANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6300 N MAIN ST, DAYTON, OH 45415-3154
(937) 275-1500
Mailing address
43 COUNTRY MANOR LN, DAYTON, OH 45458-2320
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C.1700654-TRNE
OH
Other
Enumeration date
02/22/2018
Last updated
02/22/2018
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