Individual
MS. ANITA C. SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
4001 JOHN STREET, EVANSVILLE, IN 47714-0216
(812) 473-3144
(812) 422-7558
Mailing address
415 MULBERRY STREET, EVANSVILLE, IN 47713-1230
(812) 423-7791
(812) 422-7558
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000698294
ANTHEM
IN
05
—
100240880
—
IN
01
—
12177944
CAQH
IN
Enumeration date
10/07/2010
Last updated
05/06/2011
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