Organization
DIEDRE SHAW LLC
Active
Other names
Diedre Shaw
Organization subpart
No
Provider details
NPI number
Authorized official
ASIA ALI (BILLING SPECIALIST)
(402) 413-1684
Entity
Organization
Contact information
Practice address
330 N 48TH ST STE A, LINCOLN, NE 68504-3515
(402) 326-9168
(402) 817-1172
Mailing address
330 N 48TH ST STE A, LINCOLN, NE 68504-3515
(402) 326-9168
(402) 817-1172
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026878800
—
NE
Enumeration date
05/28/2021
Last updated
11/01/2024
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