Individual
MS. ROBERTA E SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.P.C.
Contact information
Practice address
12 DAMASCUS RD, FAIRFIELD, ME 04937-4307
(207) 453-7980
(207) 649-8384
Mailing address
12 DAMASCUS RD, FAIRFIELD, ME 04937-4307
(207) 453-7980
(207) 649-8384
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC987
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128320000
—
ME
Enumeration date
01/22/2007
Last updated
04/23/2018
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