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1154795680
SUSAN SHAW
SOUTH PORTLAND, ME
NPI
1154795680
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: ME CC4414)
Enumeration Date
2015-11-20
Last Update Date
2015-11-20
Business Address
-- SUSAN SHAW LCPC
50 LYDIA LN
SOUTH PORTLAND, ME 04106-2156
Phone number: 207-331-6102
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Mailing Address
-- SUSAN SHAW LCPC
50 LYDIA LN
SOUTH PORTLAND, ME 04106-2156
Phone number: 207-331-6102
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