Individual
SHELBY AGEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CT
Contact information
Practice address
4464 S DIXIE HWY, MIDDLETOWN, OH 45005-5464
(513) 649-8008
(513) 649-8004
Mailing address
4464 S DIXIE HWY, MIDDLETOWN, OH 45005-5464
(513) 649-8008
(513) 649-8004
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
APP-000114588
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0074861
ODADAS
OH
01
—
0074946
ODMH
OH
01
—
01-0693
CARF
OH
01
—
H130910
PTAN GROUP
OH
Enumeration date
11/07/2017
Last updated
02/22/2024
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