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1770254211
LATAISHA SHAW
MYRTLE BEACH, SC
NPI
1770254211
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2021-09-24
Last Update Date
2021-09-24
Business Address
LATAISHA SHAW
104 GEORGE BISHOP PKWY
MYRTLE BEACH, SC 29579-7335
Phone number: 843-903-6212
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Mailing Address
LATAISHA SHAW
104 GEORGE BISHOP PKWY
MYRTLE BEACH, SC 29579-7335
Phone number:
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