Individual
JIMMY SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 MEGHAN LN, JUDSONIA, AR 72081-9302
(866) 729-4479
Mailing address
1009 W ARCH AVE, SEARCY, AR 72143-5213
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
A1310133
AR
Other
Enumeration date
11/07/2013
Last updated
11/07/2013
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