Individual
MICHELLE MARIE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
66 STONE ST, AUGUSTA, ME 04330-5227
(207) 626-3455
(207) 626-3612
Mailing address
66 STONE ST, AUGUSTA, ME 04330-5227
(207) 626-3455
(207) 626-3612
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC12263
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432145699
—
ME
Enumeration date
08/21/2006
Last updated
10/27/2009
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