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Individual

SHANE G LEMASTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA

Contact information

Practice address
1644 S COLLEGE AVE, FORT COLLINS, CO 80525-1007
(970) 221-0999
Mailing address
1644 S COLLEGE AVE, FORT COLLINS, CO 80525-1007
(970) 221-0999

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
NLC.0104025
CO
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACD0000714
CO

Other

Enumeration date
09/16/2014
Last updated
10/11/2016
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