Individual
JESSICA MARILYN SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5191 HAYNES RD, STOCKBRIDGE, MI 49285-9523
(517) 480-0135
Mailing address
5191 HAYNES RD, STOCKBRIDGE, MI 49285-9523
(517) 480-0135
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/19/2026
Last updated
06/19/2026
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