Individual
SHAE EWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1800 W 30TH ST, JOPLIN, MO 64804-1520
(417) 347-7580
Mailing address
PO BOX 2526, JOPLIN, MO 64803-2526
(417) 347-7580
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2018039589
MO
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
07/11/2013
Last updated
01/15/2019
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