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1043796980
SHAWN RANDALL PRENTICE
PIKETON, OH
NPI
1043796980
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date
2018-07-13
Last Update Date
2018-07-13
Business Address
SHAWN RANDALL PRENTICE
15221 STATE ROUTE 772
PIKETON, OH 45661-9062
Phone number: 937-213-0416
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Mailing Address
SHAWN RANDALL PRENTICE
1553 7TH ST
PORTSMOUTH, OH 45662-4518
Phone number: 937-213-0416
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