Most Relevant Information
Provider Data
| NPI Number: | 1003575549 |
| Provider Name: | KAYLEIGH SHAW LSW |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | 44SL06740000 |
Most Important Dates
| Enumeration Date: | 12/13/2021 |
| Last Updated: | 12/13/2021 |
Provider Practice Location
40 MORRIS LAKE RD
SPARTA
NJ
078713616
Practice Location Phone/Fax
| Phone: | 2012209345 |
| Fax: |
Provider Mailing Location
40 MORRIS LAKE RD
SPARTA
NJ
078713616
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |