JACIE SHAW

PORTLAND, ME
NPI1407162779
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: ME  MC12587)
Enumeration Date2010-08-25
Last Update Date2010-08-25
Business Address
-- JACIE SHAW
60 BUCA RUN
PORTLAND, ME 04103-1427
Phone number: 204-624-2464
Mailing Address
-- JACIE SHAW
60 BUCA RUN
PORTLAND, ME 04103-1427
Phone number: 204-624-2464