Individual
MR. WESLEY LEWIS SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MAT, BCBA, LBA
Contact information
Practice address
629 PHOENIX DR STE 115, VIRGINIA BEACH, VA 23452-7392
(757) 932-9057
(757) 743-9004
Mailing address
629 PHOENIX DR STE 115, VIRGINIA BEACH, VA 23452-7392
(757) 932-7598
(757) 743-9004
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133000525
VA
103K00000X
Behavior Analyst
1-14-16425
CA
Other
Enumeration date
03/11/2016
Last updated
02/06/2024
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