NPI 1134266950

David Jonathan Shaw, PHDLPCCCDP

Practitioner Professional Counselor Willow Grove, PA

Practice location

Address: 519 Quigley Ave, Willow Grove, PA 19090-3609
Phone: (215) 657-1416
Fax: (215) 657-0679

Registered specialties

Professional Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101YP2500X Licence PC002748 (PA)

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Registry record

NPI: 1134266950
Entity type: Individual
Sex (as registered): Male
NPI issued: 31 Jan 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.