Most Relevant Information
Provider Data
| NPI Number: | 1003386673 |
| Provider Name: | SHAUNA R GAMBLE |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | CDCA.169455 |
Most Important Dates
| Enumeration Date: | 11/27/2018 |
| Last Updated: | 07/05/2023 |
Provider Practice Location
113 W GAMBIER ST
MOUNT VERNON
OH
430502421
Practice Location Phone/Fax
| Phone: | 7403269099 |
| Fax: |
Provider Mailing Location
213 E CHESTNUT ST
MOUNT VERNON
OH
43050
Provider Mailing Phone/Fax
| Phone: | 7403269255 |
| Fax: |