Individual
KASSIDIE F SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
43 HATCH DR STE 310, CARIBOU, ME 04736-2039
(207) 493-2336
(207) 492-4889
Mailing address
180 ACADEMY ST STE 3, PRESQUE ISLE, ME 04769-3183
(207) 554-2352
(207) 554-2351
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CAC6711
ME
101Y00000X
Counselor
CAC8174
ME
101Y00000X
Counselor
—
—
Other
Enumeration date
10/01/2018
Last updated
07/25/2022
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