Individual
LAURA RENEE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
409 JAYCEE DR, ELGIN, OK 73538-5020
(832) 776-2088
Mailing address
409 JAYCEE DR, ELGIN, OK 73538-5020
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
5992
OK
Other
Enumeration date
09/25/2017
Last updated
09/25/2017
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