| NPI | 1609250240 |
|---|---|
| Former Name | ASHLEY KEONA SHAW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C010945) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-21606) |
| 101YM0800X Counselor, Mental Health (Licence: NC P009600) | |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2024-02-28 |