Tyesha Shaw
NPI #1023724762 in Disputanta, Virginia
Provider Information
- NPI Number
- 1023724762
- Entity Type
- Individual
- Name
- Tyesha Shaw
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Mental Health
- Enumeration Date
- Jan 26, 2023
- Last Updated
- Jan 26, 2023
Practice Location
- Address
- 11321 WALTON LAKE RD
- City
- Disputanta
- State
- Virginia
- ZIP Code
- 23842-4510
- Phone
- (804) 930-3280
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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