Provider Demographics
NPI:1740760867
Name:EDGEIN SHAW, JANET (MS)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:EDGEIN SHAW
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17442 NATURE WALK TRL UNIT 308
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-5263
Mailing Address - Country:US
Mailing Address - Phone:214-336-2800
Mailing Address - Fax:
Practice Address - Street 1:12650 E BRIARWOOD AVE UNIT 207
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-6792
Practice Address - Country:US
Practice Address - Phone:855-824-5669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician