Individual
CHARLES DOUGLAS SHOAFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1507
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000570003
ANTHEM BLUE CROSS AND BLUE SHIELD
OH
Enumeration date
08/29/2007
Last updated
07/10/2008
Update your record
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