| NPI | 1619926615 |
|---|---|
| Other Name | MIKE WAYNE SHAFFER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 20854) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149.011351) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2007-07-08 |