| NPI | 1235320250 |
|---|---|
| Former Name | KATIE SHAW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: PA PC003246) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA CACD) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA Certification) | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2007-08-06 |