Individual
SHANTAE MONIQUE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
258 OLD LYMAN RD, SOUTH HADLEY, MA 01075-2653
(413) 896-9094
Mailing address
E25 MILL POND RD, BROAD BROOK, CT 06016-9107
(860) 987-3035
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
04/07/2017
Last updated
04/07/2017
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