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Individual

HOLLY ELIZABETH SHAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D., LPC

Contact information

Practice address
1400 MACLOVIA ST STE 1, SANTA FE, NM 87505-3253
(505) 772-0459
Mailing address
1401 MACLOVIA ST STE 1, SANTA FE, NM 87505-3292
(505) 772-0459

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4122
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4122
LPC
CO
Enumeration date
05/14/2007
Last updated
11/20/2023
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