person
Regina Donnette Shaw
Professional Counselor in Glendale, Wisconsin
NPI 1760053813

Regina Donnette Shaw is a Professional Counselor based in Glendale, WI and is specialized in Professional. Regina Donnette Shaw practices in Glendale, WI. The NPI Number for Regina Donnette Shaw is 1760053813 and holds a License No. 4981 (Wisconsin).

The current practice location address for Regina Donnette Shaw is 1720 W Florist Ave Ste 125, Glendale, WI and can be reached out via phone at 414-247-0801 and via fax at 414-247-0816.

Location: 1720 W Florist Ave Ste 125, Glendale, WI, 53209-3862
person
Provider Profile Details
NPI Number
1760053813
Provider Name
Regina Donnette Shaw
Credential
Provider Entity Type
Individual
Gender
Female
Address
1720 W Florist Ave Ste 125, Glendale, WI, 53209-3862
Phone Number
414-247-0801
Fax Number
414-247-0816
Provider Enumeration Date
07/08/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
4981 01 WI LICENSE
institution
Provider Business Practice Location Address Details
Address
1720 W Florist Ave Ste 125
City
State
Zip
53209-3862
Phone Number
414-247-0801
Fax Number
414-247-0816
person
Provider Business Mailing Address Details
Address
1720 W Florist Ave Ste 125
City
State
Zip
53209-3862
Phone Number
414-247-0801
Fax Number
414-247-0816
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
4981 (Wisconsin)
Definition
Definition to come...
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