Individual
AMIE LYN SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA, CBHCM 1
Contact information
Practice address
2242 NW 39TH ST, OKLAHOMA CITY, OK 73112-8884
(405) 602-3171
Mailing address
2242 NW 39TH ST, OKLAHOMA CITY, OK 73112-8884
(405) 602-3171
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
9700
OK
Other
Enumeration date
07/09/2010
Last updated
07/09/2010
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