Individual
JESSICA LOUISE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BHA
Contact information
Practice address
806 G STREET, NENANA, AK 99760
(907) 452-8251
Mailing address
122 1ST AVE STE 600, FAIRBANKS, AK 99701-4899
(907) 452-8251
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
10/22/2021
Last updated
12/02/2022
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