Individual
JENNA SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7484 W MICHIGAN AVE, SUITE C, PIGEON, MI 48755-5200
(989) 453-3051
(989) 453-3052
Mailing address
443 N STATE ST, CARO, MI 48723-1539
(989) 672-6160
(989) 672-5649
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/10/2015
Last updated
09/10/2015
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