| NPI | 1780318717 |
|---|---|
| Former Name | BRITTANY MARIE SHAW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 178.018377) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2022-09-17 |