Doctor Name: | DR. DAVID JONATHAN SHAW |
NPI Number: | 1134266950 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D., LPC, CCDP |
License Number: | PC002748 |
Business Practice Address: | 519 Quigley Ave Willow Grove, PA - 190903609 |
Business Phone Number: | 2156571416 |
Business Fax Number: | 2156570679 |
Mailing Address: | 519 Quigley Ave, WILLOW GROVE |
State: | PA |
Postal Code: | 190903609 |
Phone Number: | 2156571416 |
Fax Number: | 2156570679 |
NPI Enumeration Date: | 01/31/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | PC002748 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |