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Myranda Jo Shaw
Mental Health Counselor in Burnsville, Minnesota
NPI 1801375423

Myranda Jo Shaw is a Mental Health Counselor based in Burnsville, MN and is specialized in Mental Health. Myranda Jo Shaw practices in Burnsville, MN. The NPI Number for Myranda Jo Shaw is 1801375423 and holds a License No. CC01890 (Minnesota).

The current practice location address for Myranda Jo Shaw is 1751 Southcross Dr W, Burnsville, MN and can be reached out via phone at 952-892-7690.

Location: 1751 Southcross Dr W, Burnsville, MN, 55306-7012
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1801375423
Provider Name
Myranda Jo Shaw
Credential
Provider Entity Type
Individual
Gender
Female
Address
1751 Southcross Dr W, Burnsville, MN, 55306-7012
Phone Number
952-892-7690
Fax Number
Provider Enumeration Date
08/14/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1751 Southcross Dr W
City
Burnsville
State
Minnesota
Zip
55306-7012
Phone Number
952-892-7690
Fax Number
person
Provider Business Mailing Address Details
Address
1751 Southcross Dr W
City
Burnsville
State
Minnesota
Zip
55306-7012
Phone Number
952-892-7690
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
CC01890 ()
Definition
Definition to come...
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