Individual
LYDIA SHANE HOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1750 COMMERCE CENTER BLVD, FAIRBORN, OH 45324-6333
(937) 878-8444
Mailing address
1030 CREIGHTON AVE, DAYTON, OH 45420-1926
(937) 346-7050
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/26/2018
Last updated
10/26/2018
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