Individual
AMY L SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
809 HIGH ST, DECATUR, IN 46733-2324
(260) 724-9669
Mailing address
909 E STATE BLVD, FORT WAYNE, IN 46805-3458
(260) 482-9125
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/17/2018
Last updated
08/17/2018
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