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Individual

IRENE SHAO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4350 DEWEY AVE, OMAHA, NE 68105-1017
(402) 559-6673
Mailing address
51123 PLYMOUTH LAKE CT, PLYMOUTH, MI 48170-6376
(734) 673-2197

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
07/13/2024
Last updated
07/13/2024
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