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Individual

KHANI J SHAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
801 CARNEGIE CT, LOCUST GROVE, GA 30248-2575
(470) 343-0773
Mailing address
801 CARNEGIE CT, LOCUST GROVE, GA 30248-2575
(470) 343-0773

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
171M00000X
Case Manager/Care Coordinator
251B00000X
Case Management Agency
Primary

Other

Enumeration date
02/20/2024
Last updated
02/20/2024
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