Individual
JACQUELINE ANJANETTE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.T., BCBA, LBA
Contact information
Practice address
4609 GROVE HILL CT, VIRGINIA BEACH, VA 23456-5489
(818) 456-3981
Mailing address
2085 LYNNHAVEN PKWY, SUITE 106 BOX 306, VIRGINIA BEACH, VA 23456-1497
(757) 932-9057
(757) 743-9004
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133000811
VA
Other
Enumeration date
08/16/2016
Last updated
08/16/2016
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