Individual
LACEY R SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 ARBORLAND WAY, GREENVILLE, SC 29615-2201
(864) 520-1614
(864) 484-8458
Mailing address
7500 SAN FELIPE ST STE 990, HOUSTON, TX 77063-1708
(281) 826-3382
(425) 491-7683
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-59042
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
12/13/2021
Last updated
10/30/2023
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