Individual
AUDREY SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
16 LINCOLN ST, BRUNSWICK, ME 04011-1900
(603) 883-0005
Mailing address
123 WORTHING RD, MANCHESTER, ME 04351-3234
(207) 530-1995
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CC5017
ME
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
CC5017
ME
101YS0200X
School Counselor
000591828
TN
Other
Enumeration date
04/01/2014
Last updated
06/06/2024
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