Individual
HENRIETTA F SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18451 PINEHURST ST, DETROIT, MI 48221-1956
(313) 468-4126
Mailing address
18451 PINEHURST ST, DETROIT, MI 48221-1956
(313) 468-4126
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704293238
MI
Other
Enumeration date
03/24/2016
Last updated
03/24/2016
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