Individual
MARLISA MONAE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
458 GRAND AVE, NEW HAVEN, CT 06513-3856
(203) 752-1212
Mailing address
151 PUTNAM ST, NEW HAVEN, CT 06519-2329
(475) 201-3790
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8405
CT
Other
Enumeration date
05/26/2025
Last updated
05/26/2025
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