Jacob R Shaw
Jacob R Shaw is a Peer Specialist in Basin, Wyoming. Licensed in Wyoming. Registered with an NPI since 2023.
- Licensed in
- WY
- In the registry since
- 2023
Practice location Address checks out
116 S 3rd StBasin, WY 82410
Phone: (307) 568-2020
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Peer Specialist (primary) | Taxonomy 175T00000X · Licence 143 (WY) |
|---|
Record details
| NPI number | 1396513719 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | December 14, 2023 |
| Last updated in NPPES | December 14, 2023 |
| Certification date | December 13, 2023 |