Individual
LARA JEAN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1200 LOCUST ST, ELDORADO, IL 62930-1723
(618) 252-9036
Mailing address
2222 NORTH ST, HARRISBURG, IL 62946-3421
(618) 499-4918
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.113062
IL
Other
Enumeration date
04/03/2025
Last updated
04/03/2025
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