Individual
CONISE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1401 BLOSSOM ST, ELMONT, NY 11003-2503
(347) 650-9627
Mailing address
1401 BLOSSOM ST, ELMONT, NY 11003-2503
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
118984
NY
104100000X
Social Worker
Primary
LG200002458
DC
Other
Enumeration date
06/22/2023
Last updated
06/22/2023
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