Most Relevant Information
Provider Data
| NPI Number: | 1003354804 |
| Provider Name: | SHAWN HALVERSTADT LCDC III |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 1211148 |
Most Important Dates
| Enumeration Date: | 02/01/2017 |
| Last Updated: | 02/02/2017 |
Provider Practice Location
49 PUEBLO LN
COLUMBIANA
OH
444088407
Practice Location Phone/Fax
| Phone: | 3306923395 |
| Fax: |
Provider Mailing Location
49 PUEBLO LN
COLUMBIANA
OH
444088407
Provider Mailing Phone/Fax
| Phone: | 3306923395 |
| Fax: |