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General NPI Number Information
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NPI Number | 1780041558
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Entity Type | Individual
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Provider Name | DR. JENNIFER SHAW
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Gender | Female
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Dates
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Enumeration Date | 01/25/2016
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 165 SAM SIBLEY DRIVE
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City | NATCHITOCHES
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State | LA
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Zip | 71497-0001
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Country | US
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Telephone | 318-357-4650
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Fax |
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Provider Business Mailing Address
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Address Line | 2525 YOUREE DR
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City | SHREVEPORT
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State | LA
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Zip | 71104-3671
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Country | US
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Telephone | 318-742-3408
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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