Individual
MARK E SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW LMFT
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3410
WI
106H00000X
Marriage & Family Therapist
247
WI
Other
Enumeration date
07/14/2006
Last updated
10/18/2018
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