Individual
MS. ANNETTE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
46 RIVERSIDE DR, BINGHAMTON, NY 13905
(607) 761-3178
(607) 772-2091
Mailing address
46 RIVERSIDE DR, BINGHAMTON, NY 13905
(607) 761-3178
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R30626
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109835
VALUE OPTIONS
—
01
—
4542168
AETNA
—
Enumeration date
10/05/2006
Last updated
10/04/2023
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