Individual
ABIGAIL SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 N GRAND AVE APT 57, TAHLEQUAH, OK 74464-7063
(918) 348-9262
Mailing address
1000 N GRAND AVE APT 57, TAHLEQUAH, OK 74464-7063
(918) 348-9262
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/16/2019
Last updated
01/16/2019
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