Individual
MARY LEONIE RICHARD SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
409 SECOND AVE NW, CULLMAN, AZ 35055
(256) 739-4910
(256) 739-9455
Mailing address
409 SECOND AVE NW, CULLMAN, AZ 35055
(256) 739-4910
(256) 739-9455
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
1019709
AL
Other
Enumeration date
07/28/2006
Last updated
07/08/2007
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