Individual provider · Type 1 NPI

Shane M. Clubb, M.A., L.C.P.C.

Mental Health Counselor · Meridian, ID

NPI number 1871554584 Active

About NPI 1871554584

Shane M. Clubb, M.A., L.C.P.C.'s National Provider Identifier is 1871554584, issued on Mar 31, 2006. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Meridian, ID. The record was last updated on Dec 10, 2012.