Individual
ANGELA ROSE SHAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
14761 STATE ROUTE 93 UNIT 4, JACKSON, OH 45640-9820
(740) 577-3100
Mailing address
14761 ST RT 93 UNIT 4, JACKSON, OH 45640
(740) 208-6923
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
176433
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176433
—
OH
Enumeration date
04/19/2021
Last updated
04/19/2021
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