Individual
MS. REBECCA SHAFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
3333 BURNET AVE, ML - 4002, CINCINNATI, OH 45229-3026
(513) 636-9645
(513) 636-3800
Mailing address
3333 BURNET AVE, ML - 4002, CINCINNATI, OH 45229-3026
(513) 636-9645
(513) 636-3800
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
20042577A
IN
103TC0700X
Clinical Psychologist
Primary
7014
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000785009
ANTHEM
IN
05
—
201086690
—
IN
Enumeration date
01/24/2011
Last updated
06/10/2013
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