Individual
GREGORY SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCABA
Contact information
Practice address
2400 SCIENCE PKWY, OKEMOS, MI 48864-5506
(571) 374-8066
(517) 374-5912
Mailing address
2400 SCIENCE PKWY, OKEMOS, MI 48864-5506
(571) 374-8066
(517) 374-5912
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-16-7437
MI
Other
Enumeration date
12/20/2016
Last updated
12/20/2016
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