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1154556918
MARK M. SHAW
VACAVILLE, CA
NPI
1154556918
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TF0200X Psychologist, Forensic
(Licence: CA PSY 15079)
Enumeration Date
2009-05-22
Last Update Date
2009-05-22
Business Address
-- MARK M. SHAW Ph.D.
1600 CALIFORNIA DR
VACAVILLE, CA 95687
Phone number: 707-449-6504
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Mailing Address
-- MARK M. SHAW Ph.D.
PO BOX 9811
BERKELEY, CA 94709-0811
Phone number:
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