Provider Demographics
NPI:1316511967
Name:GALBERTH, SHAWNAE NICOLE
Entity type:Individual
Prefix:
First Name:SHAWNAE
Middle Name:NICOLE
Last Name:GALBERTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 N HURON ST
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-2325
Mailing Address - Country:US
Mailing Address - Phone:614-329-4335
Mailing Address - Fax:
Practice Address - Street 1:429 N HURON ST
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-2325
Practice Address - Country:US
Practice Address - Phone:614-329-4335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHUZ966260103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service