Individual
SUSAN L. SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1205 22ND AVE, MERIDIAN, MS 39301-4010
(601) 483-2864
Mailing address
12391 HIGHWAY 491 S, UNION, MS 39365-8538
(601) 513-2476
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C6447
MS
Other
Enumeration date
11/18/2021
Last updated
12/01/2021
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