Individual
KATI-LYNNE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
153 HAZARD AVE, ENFIELD, CT 06082-4592
(860) 253-5020
(860) 253-5030
Mailing address
391 POMFRET ST, PUTNAM, CT 06260-1852
(860) 963-4971
(860) 963-4979
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/25/2014
Last updated
07/21/2022
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