Individual
WAYNE LYMAR SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1737 SE TIFFANY CLUB PL, PORT SAINT LUCIE, FL 34952-7573
(772) 985-4110
Mailing address
1737 SE TIFFANY CLUB PL, PORT SAINT LUCIE, FL 34952-7573
(772) 985-4110
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CBHCM0108439
FL
Other
Enumeration date
05/23/2026
Last updated
05/23/2026
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