Roger Allen Shaw, LMFT
NPI #1639373236 in Bloomington, Illinois
Provider Information
- NPI Number
- 1639373236
- Entity Type
- Individual
- Name
- Roger Allen Shaw, LMFT
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Marriage & Family Therapist
- Credential
- LMFT
- Enumeration Date
- Jun 14, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 1003 MARTIN LUTHER KING DR
- City
- Bloomington
- State
- Illinois
- ZIP Code
- 61701-1429
- Phone
- (309) 820-3500
Specialties & Taxonomy Codes
| Specialty |
|---|
| Marriage & Family Therapist |
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