Individual
JOHN SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8425 DORSEY CIR STE 102, MANASSAS, VA 20110-4595
(540) 300-2789
Mailing address
12714 OCCOQUAN RD, WOODBRIDGE, VA 22192-2721
(202) 436-5459
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701012978
VA
Other
Enumeration date
11/30/2023
Last updated
11/30/2023
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