| Doctor Name: | MRS. JENNY GRACE SHAW |
| NPI Number: | 1164753752 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMHC, CPT, CWS |
| License Number: | MHC 207 |
| Business Practice Address: | 1450 S Kihei Rd B201 Kihei, HI - 967538154 |
| Business Phone Number: | 8083445404 |
| Business Fax Number: | |
| Mailing Address: | 1450 S Kihei Rd, B201 KIHEI |
| State: | HI |
| Postal Code: | 967538154 |
| Phone Number: | 8083445404 |
| Fax Number: | |
| NPI Enumeration Date: | 01/20/2010 |
| NPI Last Update Date: | 01/20/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MHC 207 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | HI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |