Individual
KAYLEEN MARIE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4152 COUNTY ROAD 436, JACKSON, MO 63755-8411
(573) 225-9226
Mailing address
4152 COUNTY ROAD 436, JACKSON, MO 63755-8411
(573) 225-9226
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2020003145
MO
Other
Enumeration date
06/09/2020
Last updated
06/09/2020
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