Individual
LAURYN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9802 NICHOLAS ST STE 395, OMAHA, NE 68114-2168
(402) 252-1363
Mailing address
311 BOULEVARD OF AMERICAS STE 304, LAKEWOOD, NJ 08701-4788
(402) 252-1363
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-242783
NE
Other
Enumeration date
11/07/2022
Last updated
11/07/2022
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