Sage Bradley Shaw, LMLP

NPI #1801554779 in Ottawa, Kansas

Provider Information

NPI Number: 1801554779
Entity Type: Individual
Name: Sage Bradley Shaw, LMLP
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Psychologist
Credential: LMLP
Enumeration Date: Dec 7, 2021
Last Updated: Mar 9, 2025

Practice Location

Address: 109 W 2ND ST STE A
City: Ottawa
State: Kansas
ZIP Code: 66067-2212
Phone: (785) 242-2991

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X	Primary

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