Individual provider · Type 1 NPI
Jeremiah Lawrence Shaw
Mental Health Counselor · San Diego, CA
NPI number
1457542870
Active
Practice location
2155 Felspar St, Apt 1
San Diego, CA 92109-3624
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
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About NPI 1457542870
Jeremiah Lawrence Shaw's National Provider Identifier is 1457542870, issued on Aug 9, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in San Diego, CA. The record was last updated on Aug 9, 2007.