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Individual
GABRIELLE M SHAW
Active
Individual
GABRIELLE M SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PBT,
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
IN
101YM0800X
Mental Health Counselor
—
IN
171M00000X
Case Manager/Care Coordinator
—
IN
246RM2200X
Medical Laboratory Technician
—
IN
246RP1900X
Phlebotomy Technician
60512
IN
251B00000X
Case Management Agency
—
IN
Other
Enumeration date
02/15/2022
Last updated
03/28/2022
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