Individual
MELISSA CLARE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
478 MAVERICK LN, POPLAR BLUFF, MO 63901-6575
(562) 686-8660
Mailing address
PO BOX 1834, POPLAR BLUFF, MO 63902-1834
(562) 686-8660
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
AMFT113382
CA
106H00000X
Marriage & Family Therapist
AMFT113382
CA
106H00000X
Marriage & Family Therapist
Primary
LMFT141102
CA
Other
Enumeration date
09/12/2019
Last updated
09/15/2023
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