Individual
ANTWANA SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 LUCY LN APT 208, CHESAPEAKE, VA 23320-4460
(757) 779-4166
Mailing address
201 LUCY LN APT 208, CHESAPEAKE, VA 23320-4460
(757) 779-4166
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
VA
Other
Enumeration date
11/27/2024
Last updated
11/27/2024
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