Individual
JASON CORBETT SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2801 C CT, ASHTABULA, OH 44004-4577
(440) 998-4210
(440) 998-6489
Mailing address
2801 C CT, ASHTABULA, OH 44004-4577
(440) 990-3461
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/13/2022
Last updated
10/13/2022
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