Individual
MR. SHANE RYAN GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
225 CALHOUN STREET, SUITE 200, CINCINNATI, OH 45219-1587
(513) 556-0648
(513) 556-2302
Mailing address
MAIL LOCATION 0034, CINCINNATI, OH 45221-0034
(513) 556-0648
(513) 556-2302
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
P.07648
OH
Other
Enumeration date
11/03/2017
Last updated
11/03/2017
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