Individual
ANGIE JANE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
195 N 1950 W, SALT LAKE CITY, UT 84116-3100
(801) 462-5114
Mailing address
195 N 1950 W, SALT LAKE CITY, UT 84116-3100
(801) 462-5114
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
7434446-3502
UT
261QP0905X
State or Local Public Health Clinic/Center
Primary
7434446-3502
UT
Other
Enumeration date
10/04/2024
Last updated
10/04/2024
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