Individual provider · Type 1 NPI
Jacob R. Shaw
Peer Specialist · Basin, WY
NPI number
1396513719
Active
Practice location
116 South 3rd Street
Basin, WY 82410
Mailing address
1114 Lane 12
Lovell, WY 82431-9555
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Peer Specialist Primary | 175T00000X | 143 (WY) |
Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
2 other providers at this address
About NPI 1396513719
Jacob R. Shaw's National Provider Identifier is 1396513719, issued on Dec 14, 2023. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Basin, WY. The record was last updated on Dec 14, 2023.