Provider Demographics
NPI:1356656573
Name:CHAMBERLAIN, CECELIA SHIREEN (AUD)
Entity Type:Individual
Prefix:DR
First Name:CECELIA
Middle Name:SHIREEN
Last Name:CHAMBERLAIN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:872A E. FRANKLIN ST.
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-5610
Mailing Address - Country:US
Mailing Address - Phone:937-435-0423
Mailing Address - Fax:
Practice Address - Street 1:872 E FRANKLIN ST STE A
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-5610
Practice Address - Country:US
Practice Address - Phone:937-435-0423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA01746231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist