Individual
ERICA SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4910 STENGEL AVE, TOLEDO, OH 43614-5259
(419) 343-6422
Mailing address
4910 STENGEL AVE, TOLEDO, OH 43614-5259
(419) 343-6422
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SY529387
—
OH
Enumeration date
06/21/2019
Last updated
06/21/2019
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