Brooklyn Shaw

NPI #1902596083 in Normal, Illinois

Provider Information

NPI Number: 1902596083
Entity Type: Individual
Name: Brooklyn Shaw
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: May 11, 2023
Last Updated: May 11, 2023

Practice Location

Address: 1302 FRANKLIN AVE STE L500
City: Normal
State: Illinois
ZIP Code: 61761-3551
Phone: (309) 834-0080

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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