Individual
MS. ANTRAMEKA W SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1700 LAKE ST, LAKE PROVIDENCE, LA 71254-5208
(318) 559-0414
Mailing address
1700 LAKE ST, LAKE PROVIDENCE, LA 71254-5208
(318) 418-6858
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
CO
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/23/2023
Last updated
11/16/2023
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