Individual
ANGEL K SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1608 S ELWOOD AVE, TULSA, OK 74119-4208
(918) 587-3888
(918) 587-3894
Mailing address
1608 S ELWOOD AVE, TULSA, OK 74119-4208
(918) 587-3888
(918) 587-3894
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366568602
—
OK
Enumeration date
09/24/2008
Last updated
09/24/2008
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