Individual
NIRVANA P. SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
329 BATH RD, BRUNSWICK, ME 04011-2609
(207) 373-3012
Mailing address
PO BOX 576, NEWCASTLE, ME 04553-0576
(207) 441-2145
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC6284
ME
Other
Enumeration date
10/06/2006
Last updated
08/13/2007
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