Most Relevant Information
Provider Data
| NPI Number: | 1003222423 |
| Provider Name: | SHEA KVACHUK LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: | C.2203765-TRNE |
Most Important Dates
| Enumeration Date: | 07/07/2014 |
| Last Updated: | 08/01/2023 |
Provider Practice Location
1020 WOODMAN DR STE 330
DAYTON
OH
454321410
Practice Location Phone/Fax
| Phone: | 9372530606 |
| Fax: |
Provider Mailing Location
1020 WOODMAN DR STE 330
DAYTON
OH
454321410
Provider Mailing Phone/Fax
| Phone: | 9372530606 |
| Fax: |