Individual
ALEESIA MAKENSI SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2775 STATE ROUTE 39, SHELBY, OH 44875-9466
(419) 747-3322
Mailing address
596 STRAUB RD W APT G, MANSFIELD, OH 44904-1865
(567) 274-8786
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.184260
OH
104100000X
Social Worker
S.2302957-TRNE
OH
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/18/2022
Last updated
05/03/2023
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